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How Pre-implantation Genetic Testing can improve IVF Success Rates?

How Pre-implantation Genetic Testing can improve IVF Success Rates?

2 July 2024

How Pre-implantation Genetic Testing can improve IVF Success Rates?

In vitro fertilization (IVF) is a hope for many couples struggling with infertility. However, the journey to successful pregnancy can be faced with challenges. Pre-implantation Genetic Testing (PGT) is a powerful tool that can significantly enhance the chances of success in IVF by ensuring that only the healthiest embryos are selected for implantation. This blog delves into the intricacies of PGT and its potential to improve IVF outcomes.

Understanding Pre-implantation Genetic Testing (PGT)

Pre-implantation Genetic Testing is a sophisticated technique used to examine the genetic health of embryos created through IVF. There are three primary types of PGT:

  • PGT-A (Aneuploidy): Screens for chromosomal abnormalities, ensuring the correct number of chromosomes.

  • PGT-M (Monogenic disorders): Detects specific genetic disorders caused by mutations in a single gene, such as cystic fibrosis or sickle cell anaemia.

  • PGT-SR (Structural rearrangements): Identifies structural chromosomal abnormalities, such as translocations or inversions.

The process begins with the biopsy of a few cells from the embryo, which are then analyzed to detect any genetic issues. This allows fertility specialists to select the healthiest embryos for transfer, increasing the likelihood of a successful pregnancy.

The Importance of Genetic Screening in IVF

Genetic health is a critical factor in the success of an IVF cycle. Embryos with genetic abnormalities are less likely to implant successfully or may result in miscarriage. By screening embryos for genetic issues before implantation, PGT helps to:

  • Ensure only chromosomally normal embryos are transferred.
  • Reduce the risk of miscarriage.
  • Increase the overall success rates of IVF cycles.

How PGT Enhances IVF Success Rates?

  1. Increased chances of implantation: By selecting embryos with the correct number of chromosomes, PGT improves the likelihood of successful implantation. Embryos with chromosomal abnormalities often fail to implant or result in early pregnancy loss.

     

  2. Reduced risk of miscarriage: Miscarriages are often caused by genetic abnormalities. PGT allows for the identification and exclusion of these embryos, thereby reducing the risk of miscarriage and increasing the chances of a successful, healthy pregnancy.

     

  3. Higher pregnancy rates: Studies have shown that the use of PGT can significantly improve pregnancy rates. For instance, a study published in Fertility and Sterility found that PGT-A increased the live birth rate per transfer by selecting embryos with the highest implantation potential.

Who should consider PGT?

PGT is particularly beneficial for certain groups of patients:

  • Women of advanced maternal age: As women age, the risk of chromosomal abnormalities in embryos increases. PGT helps to identify healthy embryos, improving the chances of a successful pregnancy.

  • Couples with recurrent miscarriages: PGT can identify genetic issues that may be causing recurrent pregnancy loss.

  • Couples with a family history of genetic disorders: For those with known genetic conditions, PGT-M can screen for specific disorders, reducing the risk of passing these conditions on to the child.

  • Patients with previous IVF failures: PGT can help identify underlying genetic issues that may be causing repeated IVF failures.

The PGT Procedure: Step-by-Step

  1. Egg retrieval and fertilization: The IVF process begins with the retrieval of eggs from the ovaries, which are then fertilized with sperm in the laboratory.

  2. Embryo biopsy: On the fifth or sixth day of embryo development, a few cells are carefully removed from each embryo.

  3. Genetic analysis: The biopsied cells are sent to a genetic testing lab, where they are analyzed for chromosomal abnormalities or specific genetic disorders.

  4. Embryo transfer: Based on the results, the healthiest embryos are selected and transferred to the uterus.

Benefits and Limitations of PGT

Benefits:

  • Improved success rates: PGT significantly increases the likelihood of a successful pregnancy by selecting genetically healthy embryos.

  • Healthier pregnancies: Reduces the risk of genetic disorders and miscarriages, leading to healthier pregnancies and babies.

  • Emotional and Financial relief: By improving the chances of success, PGT can reduce the emotional and financial burden of multiple IVF cycles.

Limitations:

  • Cost: PGT adds to the overall cost of IVF, which may be a consideration for some couples.

  • Potential risks: The biopsy process, while generally safe, carries a small risk of damaging the embryo.

  • Accuracy limitations: While highly accurate, PGT is not infallible and may not detect all genetic abnormalities.

Ethical and Psychological Considerations

Ethical debates: The use of genetic testing in embryos raises ethical questions about genetic selection and the potential for “designer babies.” It’s important to balance the desire for a healthy child with ethical considerations.

Psychological impacts: The decision to undergo PGT can be emotionally taxing. Couples may experience anxiety about the results and the implications for their future family. Counselling and support from fertility specialists can help navigate these challenges.

Advances in PGT Technology

Latest developments: Technological advancements continue to improve the accuracy and efficiency of PGT. Innovations such as next-generation sequencing (NGS) have enhanced the ability to detect genetic abnormalities with greater precision.

Future prospects: Emerging technologies, such as non-invasive PGT, hold promise for even safer and more accurate genetic testing in the future. These advancements may further improve IVF success rates and expand the potential applications of PGT.

Conclusion

Pre-implantation Genetic Testing is a powerful tool that can significantly enhance the success rates of IVF by ensuring that only the healthiest embryos are selected for implantation. By increasing the chances of implantation, reducing the risk of miscarriage, and improving pregnancy rates, PGT offers hope to many couples struggling with infertility. 

If you are considering IVF, consult with the specialists at Bavishi Fertility Institute to explore whether PGT is the right option for you.

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

  • The success rate of IVF with PGT can vary depending on various factors such as the patient’s age, the quality of the embryos, and the specific type of genetic testing used. However, studies have shown that PGT can significantly improve implantation and pregnancy rates, often increasing the live birth rate per transfer.
  • Yes, PGT is generally considered safe for the embryos. The biopsy involves removing a few cells from the embryo, which typically does not harm its development. However, like any medical procedure, there are small risks involved, and it’s important to discuss these with your fertility specialist.
  • If no genetically normal embryos are identified, the IVF cycle may not proceed to embryo transfer. Your fertility specialist will discuss the findings with you and explore alternative options, such as another IVF cycle or using donor eggs or sperm.
  • PGT is not necessarily recommended for all IVF patients. It is particularly beneficial for those with a higher risk of genetic abnormalities, such as women of advanced maternal age, couples with a history of genetic disorders, or those with recurrent IVF failures. Your fertility specialist can help determine if PGT is appropriate for your situation.
  • PGT can add a few days to the overall timeline of an IVF cycle due to the time required for the biopsy and genetic analysis. However, this additional time can be invaluable in ensuring the healthiest embryos are selected for transfer, potentially saving time and emotional distress in the long run.
  • PGT primarily focuses on genetic abnormalities and chromosomal issues. It does not typically identify non-genetic issues such as structural problems in the embryo that may affect implantation or development.
  • Studies have shown that PGT can improve live birth rates compared to traditional IVF by ensuring that only chromosomally normal embryos are transferred. However, success rates can vary based on individual circumstances.

PGT can help with family balancing by allowing couples to select embryos of a specific sex for transfer. This is particularly useful for families who wish to have children of both genders and can help avoid sex-linked genetic disorders

  • Before deciding to undergo PGT, consider factors such as your medical history, the potential benefits and risks, the cost, and your ethical and personal beliefs. Discussing these aspects with your fertility specialist can help you make an informed decision.
  • Lifestyle factors such as diet, stress, and overall health can impact the quality of eggs and sperm, and consequently the quality of embryos. Maintaining a healthy lifestyle can improve the chances of producing high-quality embryos that are more likely to pass PGT screening.
  • Embryos are typically selected for PGT based on their developmental stage and appearance under the microscope. The most advanced and morphologically normal embryos are usually chosen for biopsy.

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