Preimplantation genetic diagnosis (PGD) is a technique used to diagnose the genetic disorder in embryos produced outside the womb. PGD can identify those embryos which are affected, unaffected, or a carrier for the particular disease.
Preimplantation genetic diagnosis (PGD) starts with the process of in vitro fertilization (IVF) in which Oocyte collection and fertilization is done in the laboratory. After 3-5 days, the embryos will divide into multiple cells. Then a couple of cells are taken out with the help of fine glass needle from the embryos to check for any kind genetic abnormality. After PGD analysis, if selected embryos are free from genetic problems, then only it is placed inside the uterus.
The technique was developed as a substitute to diminish the transmission of severe genetic diseases in offspring. It is helpful for those couples who have a high-risk of the genetic disorder. PGD testing is indicated when the patient has:
- Family history or Presence of any genetic disorders
- Persistent IVF Failure
- Maternal Age
- Frequent Pregnancy Loss
Family history of genetic disorders
The genetic disorder often runs in the family history from generation to generation. Pre-implantation Genetic Diagnosis (PGD) helps to avoid the genetic disorder transmission to the child. Genetic problems like Cystic fibrosis, Huntington’s disease, muscular dystrophy, Tay-Sachs disease, sickle cell anemia, can be detected with the help of PGD technique. With the help of Pre-implantation Genetic Screening (PGS), unaffected embryos are transferred into the mother’s uterus.
Persistent IVF Failure
After multiple IVF cycles if no pregnancy occurs then there is a risk of the irregular chromosomal disorder. Morphologically fine embryos often appear normal but may be chromosomally anomalous. Pre-implantation Genetic Screening (PGS) screens the normal embryo may be transferred to the uterus to have a healthy and successful pregnancy.
The risk of Chromosome genetic abnormality increases with the maternal age. When a woman is born, her ovaries have millions of eggs. With the age, the quality and number of egg deprived and by the time women reach to menopause all eggs are almost gone. Older women have lower quality eggs so there is a chance to have an abnormal embryo. In advanced maternal age, there are fewer pregnancy rates with more chances of miscarriages. An abnormal embryo is an aneuploid (An extra or missing chromosome) for example Down syndrome (Trisomy 21) has an additional copy of chromosome 21. Such risk occurs when a woman reaches the age of 35 and above.PGS helps to diminish the risk of miscarriage & helps to raise a chance for pregnancy.
Frequent Pregnancy Loss
The recurring fetal Loss is due to the following reasons:
- Chromosomal structural abnormalities
- Coagulation Disorders, Autoimmune, Endocrine, Metabolic Disorders and abnormality of the uterus
- Unexplained Loss of fetus
In case of Chromosomal structural abnormalities, there are more miscarriages because of embryo made of abnormal chromosomes. So, in that case, options are to use donor eggs or sperm to replace the abnormality using PGS with IVF.
Recurrent Pregnancy loss can be identified by the potential causes. And once the abnormality is identified, a possible treatment can be used to treat abnormality. Medical rehabilitation is required to treat endocrine, autoimmune, or metabolic diseases whereas the surgical process can be done to correct a uterine malfunction.
Couples with unexplained fetal loss have a propensity to have chromosomally abnormal embryos. Through PGS chromosomally normal embryo can be selected for implantation which also reduces the miscarriage rate and can raise the birth rate.
In about 50% of our patients, being taken for IVF, the oocyte quality or quantity is the major concern. It’s very easy for us to show you the path of egg donation as it is a routine for us. But we know it is not that simple for you. Though it carries a very high success rate, but psychological implications on the recipient are very high.
The major indications for IVF with donor oocytes in REVIVA are –
- Premature ovarian failure
- Decreased ovarian reserve
- Recurrent self cycle failures with no proven endometrial or male factor.
- Genetic causes.
It takes time for the couple to accept the option of Donor eggs, but usually the desire of having a family overcomes this hesitation.
The most important concern of the couple is the quality of genes transmitted to the child. Though the anonymous egg donor is being matched to the recipient as far as possible, the concern always remains in majority of recipient; they are satisfied with their gestational contribution which creates a strong bond.
Another way of dealing with it is to keep the information of type of cycle between the couple only, it will serve you from interrogation eyes and any future problems will be avoided.
On positive note egg donation is associated with many benefit. The most important since eggs are derived from a young woman, they are more likely to produce chromosomally normal embryos and so risk of abortions and birth defects is less.
So, though egg donation is not the first choice of anyone, but it is treatment with very high success rate where it is indicated.