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Preimplantation Genetic Testing for Aneuploidy (PGT-A), formerly known as preimplantation genetic screening (PGS), is a revolutionary technique in the field of fertility treatment. In some parts of the world, it is also called the third generation in vitro fertilization (IVF). It involves screening embryos created through IVF for chromosomal abnormalities before implantation.
Human embryos should ideally have 46 chromosomes, arranged in 23 pairs. Any deviation from this number can lead to failed implantation, miscarriage, or genetic conditions such as Down syndrome, which is caused by an extra copy of chromosome 21.
PGT-A helps ensure that only embryos with the correct number of chromosomes are transferred to the uterus, thereby increasing the likelihood of a successful pregnancy after implantation and reducing the risk of miscarriage.
The process begins with IVF, where eggs are retrieved from the ovaries and fertilized with sperm in a laboratory setting to create embryos. On the fifth or sixth day of development, when the embryos have reached the blastocyst stage, a few cells are biopsied from each embryo. These cells are then analyzed using advanced genetic sequencing techniques to detect chromosomal abnormalities. The embryos are categorized based on their chromosomal makeup, and only non-aneuploid embryos (those with the correct number of chromosomes) are selected for transfer to the uterus.
PGT-A offers several significant benefits in fertility treatment:
1. Increased Pregnancy Rates per Embryo Transfer: By selecting only chromosomally normal embryos for transfer, PGT-A significantly increases the chances of successful implantation and pregnancy. This is particularly beneficial for individuals and couples with advanced maternal age, male factor infertility, history of recurrent miscarriages or multiple failed IVF cycles.
2. Reduced Risk of Miscarriage: Aneuploid embryos are a leading cause of miscarriage. By identifying and excluding these embryos, PGT-A reduces the risk of miscarriage, providing a more reliable path to a healthy pregnancy.
3. Fewer IVF Embryo Transfer Cycles: PGT-A helps identify the most viable embryos in a single IVF cycle, reducing the need for multiple embryo transfer cycles and the associated physical, emotional, and financial burdens.
PGT-A is particularly recommended for:
• Women of advanced maternal age (35 years and older), as the risk of chromosomal abnormalities increases with age.
• Couples with a history of recurrent miscarriages.
• Severe male factor infertility.
• Couples with repeated IVF failures.
• Individuals or couples with a history of chromosomal abnormalities.
While PGT-A offers many advantages, it also raises ethical and practical considerations. The procedure adds to the overall cost of IVF, making it less accessible to some patients. Additionally, the biopsy process, although generally safe, carries a small risk of damaging the embryo. Ethical debates also surround the selection process, as it involves making decisions about which embryos to implant based on genetic criteria.
PGT-A represents a significant advancement in assisted reproductive technology, providing a powerful tool to improve IVF outcomes. By enabling the selection of chromosomally normal embryos, PGT-A shortens the time to achieve a successful pregnancy, reduces the risk of miscarriage, and offers hope to many individuals and couples struggling with infertility. As with any medical procedure, it is essential to discuss the benefits and risks with a fertility specialist to determine if PGT-A is the right option for your unique situation.
