Pre-implantation genetic diagnosis (PGD) is a method aimed at eliminating embryos created by in vitro fertilization (IVF), which has abnormal chromosomes or carries a serious genetic disease before the onset of pregnancy. Genetic diagnosis of preimplantation (PGD) refers specifically to when one or both genetic parents have a known genetic abnormality, and testing is performed at the embryonic level to determine if it carries a genetic abnormality. These structural or numerical defects in embryos are more common in elderly pregnant women, especially those over 35 years of age. This situation can lead to infertility, because it reduces the likelihood of implantation, and also causes unwanted miscarriages. In fact, 40 out of 100 pregnancies in women aged 39 years and older will lead to problems associated with structural or numerical chromosomal defects. In contrast, genetic preimplantation screening (PGS) refers to methods in which embryos from putative chromosomal genetic parents are screened for aneuploidy.
Since only implanted embryos are transferred to the uterus for implantation, genetic testing of preimplantation is an alternative to the diagnostic procedures of modern diagnostics, which are often accompanied by a difficult solution to abortion if the results are unfavorable. PGD and PGS are currently the only options that allow you to avoid a high risk of your baby being infected with a genetic disease before implantation. This is an attractive way to prevent an inherited genetic disease by eliminating the dilemma of abortion after an unfavorable prenatal diagnosis.
Indications for pre-implantation Genetic screening
Most of the early pregnancy losses can be attributed to aneuploidy. Since only chromosomally normal embryos are transferred to the uterus, the risk of losing the first and second trimester is markedly reduced. There is currently no specific list of indications for genetic screening of preimplantation (PGS). For couples undergoing IVF, pre-implantation genetic diagnostics may be recommended if:
1. One or both partners have a history of hereditary genetic disorders.
2. One or both partners are carriers of a chromosomal abnormality.
3. Mother has a developed maternal age.
4. Mother has a history of repeated miscarriages.
5. The pair repeated IVF failures.
6. Male partner is faced with the problem of severe male infertility.
Thousands of clinical cycles for genetic diagnosis of pre-implantation have been performed worldwide, resulting in hundreds of healthy children.
Benefits or benefits of PGD are listed below:
The procedure is performed before implantation, thus reducing the need for amniocentesis later during pregnancy.
The procedure is performed before implantation, allowing couples to decide whether they want to continue the pregnancy.
This procedure allows couples to pursue biological children who may not have done so otherwise.
This procedure can help reduce costs, usually associated with birth defects.
In addition, hundreds of babies were born after PGD / PGS worldwide. To date, there are no reports of an increase in the incidence of fetal development or other identifiable problems.
The main reason for choosing this PGD procedure is that the risk of miscarriage during a normal pregnancy is reduced from 23 percent to 9 percent, the likelihood that the embryo attached to the uterus almost doubles, the chances of a clinical pregnancy and returning home with the baby and the frequency of multiple pregnancies going down.
How is the PGD procedure performed?
Pre-implantation genetic diagnosis (PGD) is a screening test used to determine the presence of genetic or chromosomal disorders in embryos obtained by in vitro fertilization (IVF). Below are the steps involved in performing the PGD procedure.
1. The patient's ability to PGD is assessed by a physician who specializes in the corresponding disease.
2. Then the couple is prepared for the IVF procedure.
3. An egg taken from the mother is fertilized by the father’s sperm in a laboratory environment.
4. Embryologists extract one or two blastomere cells from remote embryos using a biopsy.
5. Cells extracted by biopsy undergo a special staining technology (FISH), which allows chromosomes to be examined under a microscope after the fixation process.
6. Embryos with structural or quantitative chromosomal defects are selected and removed. Then healthy embryos are transferred to the mother’s womb.
Although PGS was included in the treatment of patients undergoing IVF treatment, its indications, usefulness and results remain an active area of research in the field of reproductive medicine. As preimplantation is optimized for medical disorders at the embryonic level, its place in medicine and society will continue to cause controversy and ethical debate.
Despite all its advantages, the cases in which this method will be used must be carefully selected. It should be remembered that the PGD procedure requires that the cell be extracted from the embryo using a biopsy. Thus, there is a chance to harm the embryo, and this procedure has a 10 percent error. Thus, it is believed that it causes more harm than good when it is performed unnecessarily.
To collect more information about pre-implantation genetic diagnosis, its procedures, treatment and the rate of succination, you can contact the clinic of the children's clinic test-tube. Iraq Middle East: Al-Manar Fertility and Endoscopy Center, based in Barah, Iraq. You can make an appointment with doctors at http://almanarfertility.com or by calling +964 7700338337
