Q: WHAT IS IVF WITH PGD, OR PREIMPLANTATION GENETIC TESTING AND PGS OR PREIMPLANTATION GENETIC SCREENING?
- PGD, preimplantation genetic diagnosis, involves removing a cell from an IVF embryo to test it for a specific genetic condition (thalassemia major, cystic fibrosis, for example) before transferring the embryo to the uterus.
- PGS, preimplantation genetic screening, is the term for testing for overall chromosomal normalcy in embryos. PGS is not looking for a specific disease diagnosis – it is screening the embryo for normal chromosome number
Q: WHO MIGHT BENEFIT FROM IVF WITH PGD?
In general, there are 5 main groups of patients that might utilize PGS or PGD (list is not exhaustive) Patients that are having IVF with advanced female age – 38 or older (common) in general, about 30-60% of human embryos have some type of chromosomal abnormality. This increases significantly with advancing female age
- Patients that are having IVF with advanced female age – 38 or older (common) in general, about 30-60% of human embryos have some type of chromosomal abnormality. This increases significantly with advancing female age .
- Patients of any age with repeated IVF failure – usually defined as 3 or more failed attempts .
- To screen for inherited genetic diseases like thalassemia, cystic fibrosis and many more disease etc. In such a scenario, PGD can clearly benefit the couple. For example, if the male partner and female partner are both carriers of a recessive disease (such as thalassemia, cystic fibrosis etc), their child (conceived naturally) would have a 25% chance of having severe form of this disease. By having IVF and PGD, they can have “normal” embryos transferred so that (if IVF is successful) their child should not have cystic fi
- Patients that are carriers of chromosomal translocations. These embryos are at very high risk for miscarriage or could result in the birth of a child with birth defects. This is another situation where PGS can help. By having IVF aneuploidy screening of the embryos, they can have chromosomally normal embryos transferred. This greatly reduces their risk for miscarriage and birth defects.
- Patients that have had recurrent miscarriages
Q: AT WHAT DIFFERENT STAGES OF DEVELOPMENT CAN AN EMBRYO BE BIOPSIED ?
- Biopsy at the cleavage stage is done on day 3 of embryo development. At this point the embryo usually has 8 to 10 cells .
- Embryos biopsied on day 5, is called blastocyst stage after which the embryo has differentiated into an inner cell mass, a trophectoderm component and a fluid filled cavity.
Q: WHICH ARE THE BEST PGD CLINICS?
- In general, the best clinics for PGD or PGS will be the clinics with the best IVF success rates.
- It is critical to have an excellent culture system in order to get a maximal number of quality blastocysts for biopsy.
- Also, the skills of the embryologist are of utmost importance to carry out such procedures.
- Very few centres in India carry out procedures of IVF with PGS/PGD due to extreme precision required for this procedure.
EGG DONOR (OOCYTE DONOR)
Egg donor program is part of IVF where in the oocytes (eggs) of an egg donor are utilized to fertilize with husbands sperms and transferred in patients uterine cavity to achieve pregnancy.
IVF WITH OOCYTE DONOR IS LEGAL IN INDIA
Who needs donor oocytes :
- Patients with premature ovarian failure
- Poor responders in IVF failing to produce good number of eggs
- Repeated IVF failure where poor embryos form resulting from poor oocyte quality
- Known genetic defect in female partner and couple not opting for preimplantation genetic testing on embryos.
HOW WILL OOCYTE DONORS BE SELECTED ?
- Oocyte donors are recruited through oocyte donor agency.
- After detailed history taking and physical examination donors are screened and necessary blood test are performed including AMH (ovarian reserve test)thalassemia screen and infectious markers (HIV, HBsAg, anti HCV and VDRL) .
- Once they are found to be suitable, their profile (except their photographs/identity) would be sent to you .
- The ovarian stimulation and monitoring for egg donors is the same as for any patients undergoing IVF.
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