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PGD | PGS
The Most Successful Gender Selection Programs 

Preimplantation Genetic Diagnosis or PGD is a method that enables couples to decide the gender of their baby. At the same time, PGD guarantees, with high certainty (around 99%), that their baby will be genetically healthy. PGD involves performing a genetic analysis on sample cells from the embryo before it is transferred to the uterus. When the embryo is old enough (on the 3rd day of development), we do a biopsy on sample cells to determine unbalanced genetic translocations and defect chromosomes 21, 18, 13, Y, and X using the FISH procedures which match the different DNA fragments for fluorescein analysis.

That way, our genetic experts screen more than 400 hereditary diseases using :

  1. Aneuploidy Screening (tests for an abnormal number of chromosome sets that can lead to birth defects,
  2. Single Cell Disorder (determines whether there are any inheritable diseases that could be passed on from the parents to their offspring), and
  3. Chromosomal Translocation (searches for translocation between chromosomes that results in the loss of genetic material).

Cyprus IVF Clinic delivers one of the most successful gender selection programs in Europe and abroad, giving couples the opportunity to choose the sex of their next child before pregnancy.

PGD | PGS
STEP BY STEP 

What is PGD IVF treatment?

On their journey to start a family soon, many couples choose PGD to give their IVF treatment improved success rates. Indeed, PGD is a much-preferred IVF method for couples at risk of passing on a genetic condition or disease. So, PGD is an excellent option for patients desiring to make sure the embryos that will be transferred to their uterus will be chromosomally normal. It is also recommended for women experiencing recurrent pregnancy loss and/or who are carriers of genetic disorders. However, PGD is a superb gender or family balancing selection, too. We will talk all about PGD right below!

PGD

What is PGD?

Preimplantation Genetic Diagnosis (PGD) is a method that was developed in the early 1900s. It enables us to test embryos for genetic defects before we perform the embryo transfer. Over the years, it has undergone major improvements, which allows us to be able to evaluate the full spectrum of chromosomes in a much more efficient way than before. So, if there is a genetic condition present in your family, you know that one of your options to reduce the risk of passing the condition onto your embryo is via PGD testing. This is particularly helpful when undergoing an IVF treatment as it improves your success rates and helps prevent a pregnancy that could potentially be affected by a chromosomal disorder or genetic condition.

To date, there are several different types of PGD. Since each case is different, it is advised to discuss these with your physician, who will determine the right one based on your individual needs. Or, you could schedule an appointment with us and have one of our fertility experts screen you and evaluate your case.

The Different Types of PGD

Some of the most commonly used types of PGD are as follows:
Single Gene Disorders – We recommend this solution to patients undergoing IVF who are found to be either affected or carriers of a genetic disorder that runs in the family. As soon as this gene is identified, we perform PGD on select embryos (those that don’t carry the gene). Huntington disease, Tay-Sachs disease, sickle cell disease, and cystic fibrosis are some of these single-gene disorders. PGD can identify nearly all genetic disorders linked to a particular gene.
Limited chromosomal screening – This type of PGD looks at around 3-5 chromosomes as a means to help evaluate chromosomal 21 abnormalities, such as Down’s Syndrome and sex chromosomal abnormalities.
Comprehensive Chromosomal Screening (CCS) – We evaluate all chromosomes to ensure that all the chromosomes are in pairs, plus an XX for a female embryo and an XY for a male embryo.
The embryos that are found to be healthy are then transferred into the uterus, which gives us elevated chances of successful implantation and the delivery of a healthy baby. The following section breaks down the details involving the procedure of PGD testing. That way, you can have a deeper understanding of the process required and enter into it feeling empowered and confident.

PGD – A step by step guide to the procedure

It should be noted that, the fact that PGD is performed before the embryo implantation dramatically reduces (even negates) the need for amniocentesis later in pregnancy.

1

Review of your case & probe development

There is no one-size-fits-all solution with PGD. Each case is different, so each PGD test is custom-designed to suit the specific mutation of disease that is hereditary in a family. As soon as you receive your genetic testing results, you give them to our lab. Our gene specialists will review your results and decide whether PGD is possible. If it is, we will ask for DNA samples (i.e., sperm from the male partner, eggs from the female patient, and likely samples from parents and additional family members). We will use these samples to develop the probe, which will take several weeks to complete.

2

Ovary stimulation

As soon as the probe is finished, it is time to stimulate the ovaries to produce several eggs at once. Beginning with a larger quantity of eggs helps increase the chance of producing normal embryos that are not affected by the genetic abnormality. This is because we know for sure that some embryos will inevitably inherit the hereditary disease. To stimulate the ovaries, our reproductive IVF Specialist will prescribe fertility medication.

3

Egg Collection

Time to retrieve eggs, which is a minimally invasive process where the doctor uses ultrasound to gently guide a catheter that has a tiny needle attached to it through the vaginal wall. Using light suction, each egg will be drawn out and collected in test tubes bearing a unique ID number and the patient’s name. The embryologists now take charge, who will assess the eggs and proceed with the incubation stage.

Note that egg retrieval takes around 15-20 minutes, and you do not feel anything as you receive intravenous sedation medication for the duration of the process. You may, however, experience some mild cramping after egg retrieval.

4

Egg Fertilisation

Egg Fertilisation is done with ICSI (intracytoplasmic sperm injection) in our clinic - a typical process recommended to patients using PGD where a single sperm cell is injected into each egg.

5

Embryo culture & Biopsy

Fertilized eggs remain in the lab for 5 days until they reach the blastocyst stage, which means that they are mature enough to contain about 100-150 cells. Our embryologist then removes 2-10 cells from each embryo to perform a biopsy, which are placed in a test tube and sent for PGD testing to our sophisticated laboratory.

6

PGD Testing

Our lab specialists use the probe that has been previously developed to test embryos for the hereditary disease/mutation to test the biopsy samples. Sometimes, depending on the case, the same biopsy sample might be used to test for chromosomal abnormalities in embryos with Preimplantation Genetic Diagnosis. The results of the PGD testing per embryo are almost instantly provided by our PGD lab.

7

Embryo Transfer

Your doctor will discuss the results of your IVF and PGD cycle with you. The embryos that were not affected by the disease or condition PGD was utilised for, will be transferred into the uterus. We may recommend additional IVF cycles and egg retrievals, though, to create more embryos if the number of unaffected embryos is not satisfactory.

Notes:

Around 12 days after the embryo transfer, you will be given a pregnancy test to determine whether the implantation has been successful or not.
PGD does not always result in pregnancy. Several factors play a role and affect the chances to conceive. Overall, though, our clinic has the highest pregnancy rates in Europe, especially when using PGD for single-gene conditions.

The Difference Between PGD and PGS

The term Preimplantation Genetic Screening (PGS) is sometimes used interchangeably with Preimplantation Genetic Diagnosis. However, the two methods have some significant differences. For starters, PGD analyses biopsied cells from the embryo to detect a SPECIFIC disorder or condition that could be passed down from parents to their children. So, PGD tries to determine whether an embryo has a specific gene mutation that either one or both biological parents are already aware of having themselves. PGS, on the other hand, uses the same procedure to screen the embryo for potential hereditary abnormalities when there is no known history of inherited disorders in the family. Therefore, we recommend PGS for parents with no known hereditary abnormalities. Also, couples that meet any of the following conditions can even consider PGS:
The female partner is over 38 years of age.
Couples interested in gender selection.
History of failed IVF.
History of implantation failure.
History of recurring miscarriage.
Couples interested in a single embryo transfer.

The Difference Between PGD and PGS

The term Preimplantation Genetic Screening (PGS) is sometimes used interchangeably with Preimplantation Genetic Diagnosis. However, the two methods have some significant differences. For starters, PGD analyses biopsied cells from the embryo to detect a SPECIFIC disorder or condition that could be passed down from parents to their children. So, PGD tries to determine whether an embryo has a specific gene mutation that either one or both biological parents are already aware of having themselves. PGS, on the other hand, uses the same procedure to screen the embryo for potential hereditary abnormalities when there is no known history of inherited disorders in the family. Therefore, we recommend PGS for parents with no known hereditary abnormalities. Also, couples that meet any of the following conditions can even consider PGS:
The female partner is over 38 years of age.
Couples interested in gender selection.
History of failed IVF.
History of implantation failure.
History of recurring miscarriage.
Couples interested in a single embryo transfer.

FAQs – PGS

How safe are embryo biopsy and PGD?

Research and data from many years of PGD, combined with the hundred thousand successful pregnancies and live births in humans, indeed, indicate that the method is not tied to a rise in birth defects over that of the general population. That aside, PGD-tested embryos are associated with fewer pregnancies that result in a chromosomal disorder-related miscarriage. This is because the overwhelming majority of abnormalities are identified before the embryo transfer process. Now, some couples worry that removing cells from the early embryo may affect the embryo’s ability to develop into a normal pregnancy. There is no reason to worry about that as there is no scientific evidence to support that.

Also, children born after PGD have shown no evidence for an adverse effect on PGD on their neurological development or growth over the first years of their life.

How do you choose the embryos for transfer?

The selected embryos must have normal morphology (appearance) and test results to be considered for embryo transfer in a FET (frozen embryo transfer) cycle. That being said, it is also known that many embryos with normal morphology have significant chromosomal abnormalities. So, embryo morphology is not a determining factor in choosing the best embryos for transfer. The combination of normal physical appearance with normal genetic testing, though, is. This is where PGD comes into play, allowing us to identify the best embryos for transfer to the uterus to ensure the highest chance of conceiving and enjoying a healthy pregnancy. It should also be noted that our medical team will work hand-in-hand with you to make the needed decisions in regard to which embryo to transfer and how to use the remaining ones.

Does PGD replace prenatal testing?

The standard prenatal testing should still be carried through after the embryo transplantation despite the fact that both PGD and PGS screen for genetic abnormalities. You can discuss all about prenatal testing and other tests such as amniocentesis, choronic villus sampling, and cell-free fetal DNA testing with our medical staff.
MORE IVF PROCEDURES
With an extensive aftercare programme, Cyprus IVF Clinic are ready to handle your every fertility need. Whatever your circumstances, please contact us today for advice and guidance on making the move towards IVF.
Şehit Asteğmen, İdris Doğan Sk, No: 3, Nicosia, North Cyprus
Support: +90 539 121 02 42
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