PGD (PRE-IMPLANTATION GENETIC DIAGNOSIS)
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What is the essence of IVF donor programs?
Preimplantation genetic testing is a technique used to identify genetic defects in embryos created through in vitro fertilization (IVF) before pregnancy. Preimplantation genetic diagnosis (PGD) refers specifically to when one or both genetic parents has a known genetic abnormality and testing is performed on an embryo to determine if it also carries a genetic abnormality. Currently, we are able to perform PGD for many genetic conditions, including single gene disorders and chromosomal abnormalities.
PG testing is divided into two broad categories: diagnosis and screening.
- The purpose of PG diagnosis is to prevent the birth of affected children from parents with a known genetic abnormality, and is widely acknowledged as acceptable for routine clinical application.
- The purpose of PG screening is to identify optimal embryos for uterine transfer in an IVF cycle and, in so doing, improve pregnancy success in certain patient populations; its routine clinical application remains controversial.
Indications for PGD:
- Women of advanced maternal age (35 years and older)
- Couples with history of recurrent pregnancy loss (2 or more consecutive pregnancy losses before 20 weeks’ gestation)
- Couples with repeated IVF failure (3 or more failed IVF attempts involving high-quality embryos)
- Male partner with severe male factor infertility
CANDIDATES FOR PG DIAGNOSIS
- Carriers of autosomal recessive diseases in which both parents are known genetic carriers (such as cystic fibrosis or sickle cell disease)
- Carriers of autosomal dominant diseases in one or both parents (such as Huntington’s disease)
- Couples with a family history of X-linked disorders (such as hemophilia)
- Couples with chromosome translocations, which can cause implantation failure, recurrent pregnancy loss, mental or physical problems in offspring
Benefits of PGD
- The procedure is performed before implantation reducing the need for amniocentesis later in pregnancy.
- The procedure is performed before implantation allowing the couple to decide if they wish to continue with the pregnancy.
- The procedure enables couples to pursue biological children who might not have done so otherwise.
- The procedure may help reduce the costs normally associated with birth defects.
HOW IS THE PGD PERFORMED?
Step 1. You undergo normal in vitro fertilisation treatment to collect and fertilise your eggs.
Step 2. The embryo is grown in the laboratory for two – three days until the cells have divided and the embryo consists of around eight cells.
Step 3. Our embryologist removes one or two of the cells (blastomeres) from the embryo.
Step 4. The cells are tested to see if the embryo from which they were removed contains the gene that causes the genetic condition in the family.
Step 5. Embryos unaffected by the condition are transferred to the womb to allow them to develop.
Step 6. Any suitable remaining unaffected embryos can be frozen for later use. Those embryos that are affected by the condition are allowed to perish.
Step 7. About two weeks after the embryo transfer, the woman is given a pregnancy blood test.