What is PGTA?
Preimplantation Genetic Testing for Aneuploidy (PGT-A) is a genetic test performed on embryos created through IVF. This test checks for abnormalities in the number of chromosomes, which are known as aneuploidies. Aneuploidies are the leading cause of implantation failure and repeated miscarriages.
During PGT-A, cells are biopsied from embryos that reach the blastocyst stage (on days 5, 6 or 7 of embryo development), and DNA is extracted and analyzed in the lab to determine if there are any chromosomal abnormalities. Embryos with the correct number of chromosomes are called "euploid" and have upto a 70% chance of developing into a healthy baby1. In contrast, embryos with missing or extra chromosomes are called "aneuploid" and are the leading cause of failed implantation and miscarriage, or may even lead to a genetic condition.
Who should consider it?
PGT-A may be considered by patients who have had repeated miscarriages, multiple failed IVF cycles, or those who are of advanced maternal age, as the risk of aneuploidy increases with age. It can also be helpful for patients who want to reduce the risk of genetic conditions related to chromosomal abnormalities.
What does the research say?
The research on PGT-A is ongoing, and its benefits can vary depending on the patient's circumstances. Current studies suggest that PGT-A does not provide additional benefits for patients under 35 with a good prognosis. However, there is evidence that it may be more beneficial for women over 35, who are at a higher risk of having embryos with chromosomal abnormalities2.
Another area of research is the transfer of mosaic embryos, which are embryos with both euploiad (normal) and aneuploid (abnormal) cells. Some studies suggest that some mosaic embryos can “self-correct” and develop into healthy babies3. If you have a limited number of embryos and some are reported as mosaic, it might still be worth considering their transfer. Genetic counseling is recommended to help you make an informed decision in these cases.
It's important to understand that PGT-A is not designed to improve your overall success rate of achieving a pregnancy but rather to help select the best chromosomally normal embryos to transfer. Meaning, the procedure does not improve your chance of having a baby, but rather, decreases your time to having a baby if a chromosomally normal embryo has been identified. While it has been shown to reduce miscarriage rates, using PGT-A might decrease the number of embryos available for transfer, potentially reducing the overall chance of having a baby4.
Safety
The process of PGTA involves taking a biopsy from the embryos to test their genetic material, which can cause some stress to the embryo. The risk of damaging the embryos from the biopsy process is around 3%5,6, even though from our experience it is much lower.
myfertility’s take on PGTA
PGT-A can provide valuable information on your embryos, but we must make it very clear: it should not be prescribed for everyone. The reason we say this is because of the significant added cost it adds to your IVF bill. Like we mentioned before, we do not think clinics should have a blanked policy for all patients to do PGTA, it should be recommended on a case-by-case basis, considering your age, how long you’ve been trying for, and your fertility and obstetric history. If you are considering PGT-A, it is crucial to have thorough genetic counseling, especially when dealing with mosaic embryos. It is important to make a well-informed decision based on your unique situation and the potential risks and benefits.
Additionally, because there is always a small chance of error, we recommend undergoing prenatal genetic testing during your pregnancy to confirm the results of PGTA. This approach provides an additional layer of reassurance for expecting parents.
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