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Advantages and Disadvantages of PGT – Preimplantation Genetic Testing

Advantages and Disadvantages of PGT – Preimplantation Genetic Testing

4 July 2024

Advantages and Disadvantages of PGT - Preimplantation Genetic Testing

 Preimplantation Genetic Testing (PGT) has emerged as a pivotal advancement in fertility treatments, offering couples a way to screen embryos for genetic abnormalities before implantation. This cutting-edge technology promises to enhance IVF success rates and reduce the likelihood of genetic disorders, but it also comes with its own set of challenges. In this blog, we aim to provide a balanced view of the advantages and disadvantages of PGT, helping you make an informed decision about whether this option is right for you.

Understanding Preimplantation Genetic Testing (PGT)

Preimplantation Genetic Testing (PGT) is a technique used alongside IVF to analyze the genetic material of embryos before they are transferred to the uterus. This helps in identifying embryos with genetic abnormalities that could lead to implantation failure, miscarriage, or genetic diseases in the offspring.

Types of PGT

  • PGT-A (Aneuploidy): Screens for chromosomal abnormalities, such as Down syndrome.
  • PGT-M (Monogenic/Single Gene Disorders): Identifies specific genetic disorders like cystic fibrosis or Huntington’s disease.
  • PGT-SR (Structural Rearrangements): Detects chromosomal structural rearrangements that might lead to infertility or miscarriage.

Advantages of Preimplantation Genetic Testing

1. Improved IVF success rates

Higher implantation rates: By selecting embryos that are chromosomally normal, PGT can significantly improve the chances of successful implantation. This means fewer IVF cycles and a quicker path to pregnancy.

Reduced miscarriage rates: Miscarriages often result from chromosomal abnormalities. PGT helps in reducing the risk of miscarriage by ensuring that only genetically healthy embryos are transferred, thus providing a safer pregnancy journey.

2. Detection of genetic disorders

Preventing genetic diseases: PGT allows for the screening of embryos for specific genetic disorders that the parents might carry, thereby preventing the transmission of these conditions to the child. This is particularly valuable for couples with a known family history of genetic diseases.

Carrier screening: Even if parents are asymptomatic carriers of genetic mutations, PGT can identify these mutations in embryos, ensuring that only unaffected embryos are selected for transfer.

3. Family planning benefits

Gender selection: In regions where it is legally permissible, PGT offers the option to select the sex of the baby, which can be useful for family balancing or for avoiding sex-linked genetic diseases.

Single Embryo transfer: PGT enables the selection of a single, healthy embryo for transfer, which reduces the risks associated with multiple pregnancies, such as preterm birth and low birth weight.

4. Peace of mind

Emotional benefits: Knowing that your child is less likely to be affected by genetic disorders can provide immense peace of mind. This reassurance can be invaluable for parents, reducing anxiety and stress during pregnancy.

Disadvantages of Preimplantation Genetic Testing

1. Cost implications

Financial burden: PGT is an additional cost on top of IVF

Insurance coverage: Insurance plans vary widely, and many do not cover PGT, leaving couples to bear the full financial burden themselves.

2. Ethical and Moral concerns

Ethical dilemmas: The selection of embryos based on genetic characteristics raises ethical questions. Some argue that this practice borders on eugenics and could lead to societal implications, such as a preference for certain traits.

Discrimination: There is a potential risk of genetic discrimination, where embryos are selected based on desirable traits, leading to ethical and moral concerns about the value placed on different human characteristics.

3. Risk of Embryo damage

Procedure risks: The process of biopsying embryos for PGT can potentially damage them, which might affect their viability. Although the risk is low, it is a consideration that couples need to be aware of.

4. False Positives/Negatives

Accuracy of results: While PGT is highly accurate, there is still a possibility of false positives or false negatives. This can lead to the discarding of healthy embryos or the transfer of embryos with undetected abnormalities.

5. Emotional and Psychological impact

Emotional strain: The process of undergoing PGT, waiting for results, and dealing with the outcomes can be emotionally and psychologically taxing. Couples may experience significant stress and anxiety, particularly if results are unfavourable or inconclusive.

Balancing the Advantages and Disadvantages

Individual considerations: Deciding whether to use PGT is a deeply personal decision that should take into account individual circumstances, medical history, and personal values. What works for one couple may not be suitable for another.

Consultation with specialists: It is crucial to discuss with fertility specialists and genetic counsellors who can provide personalized advice based on your specific situation. They can help weigh the benefits and risks, ensuring you make an informed choice.

Conclusion

Preimplantation Genetic Testing (PGT) offers significant advantages, including higher IVF success rates, the prevention of genetic disorders, and the emotional reassurance of knowing your child is less likely to be affected by genetic abnormalities. However, it also comes with disadvantages such as high costs, ethical concerns, and the risk of embryo damage.

At Bavishi Fertility Institute, we are committed to helping you navigate these complex decisions with expert guidance and support. If you are considering PGT, we encourage you to reach out to Bavishi Fertility Institute to explore whether this advanced reproductive technology is right for you. Making an informed decision is the first step towards a successful and fulfilling parenthood journey.

Author Bio

Dr. Parth Bavishi

Dr. Parth Bavishi, MD in Obstetrics and Gynecology, brings over 12 years of invaluable work experience to his role as Director of Bavishi Fertility Institute, leading a group of IVF clinics committed to helping couples realise their dreams of parenthood. 

Bavishi Fertility Institute is dedicated to provide customised and personalised treatments which are simple, safe , smart and successful. Bavishi Fertility Institute works with success and satisfaction for all at heart. Providing an ideal blend of professional treatment and personalised care.

Dr Parth had special training in infertility at Bavishi fertility Institute, the Diamond Institute, USA, and the HART Institute, Japan.

Dr. Bavishi is a distinguished expert in his field. In addition to his clinical practice, Dr. Bavishi is the author of the acclaimed book, ‘Your Miracle in Making: A Couple’s Guide to Pregnancy,’ offering invaluable insights to couples navigating the complexities of fertility. He loves to empower patients to make the correct choice by education both online and offline .

His exceptional contributions have earned him the prestigious Rose of Paracelsus award from the European Medical Association. Dr Parth has been an invited faculty at many national and international conferences.

Beyond his professional endeavors, Dr. Bavishi is an avid traveller who finds solace in exploring new destinations. He also enjoys engaging his mind with brainy puzzles, always seeking new challenges and solutions outside of the medical realm.

FAQs

  • PGT (Preimplantation Genetic Testing) is a broader term that includes various types of genetic testing of embryos, such as PGT-A, PGT-M, and PGT-SR. PGD (Preimplantation Genetic Diagnosis) specifically refers to testing for monogenic or single-gene disorders (what is now termed as PGT-M).
  • The PGT process typically takes a few days to a week after the embryos have been biopsied. This time frame allows for the analysis of the genetic material and the preparation of results.
  • The PGT process involves a biopsy of the embryos, which is performed by highly skilled embryologists. It does not cause pain to the embryos. For the mother, the procedure is part of the standard IVF cycle, and any discomfort would be related to the IVF process itself, not the PGT.

Success rates with PGT vary based on factors such as the woman’s age, the quality of the embryos, and the specific genetic conditions being tested. Generally, PGT can improve the chances of a successful pregnancy by ensuring only chromosomally normal embryos are transferred.

  • While PGT can detect many chromosomal abnormalities and specific genetic disorders, it cannot detect all possible genetic issues. It is important to discuss the scope of testing with your fertility specialist.
  • Unused embryos may be frozen for future use, donated for research, donated to other couples, or respectfully discarded, depending on the couple’s preferences and the clinic’s policies.
  • Currently, PGT is primarily used for medical reasons, such as identifying chromosomal abnormalities and genetic disorders. The use of PGT for non-medical traits, such as eye color, raises significant ethical concerns and is not widely practiced or recommended.
  • Couples should undergo thorough counseling and genetic consultation to understand the process, benefits, risks, and limitations of PGT. Preparing emotionally and financially is also crucial.
  • Alternatives include prenatal testing methods like Chorionic Villus Sampling (CVS) and amniocentesis, which are performed during pregnancy. However, these methods do not allow for the selection of embryos prior to implantation.
  • PGT is particularly suitable for couples with a history of genetic disorders, recurrent miscarriages, or infertility issues related to chromosomal abnormalities. It is also beneficial for older women undergoing IVF, as the risk of chromosomal abnormalities increases with age.
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