What is Preimplantation Genetic Testing?
Embryos produced by In Vitro Fertilization (IVF) are grown for 5-6 days until they reach the blastocyst stage. In the blastocyst stage, the embryo is composed of two different kinds of cells:
- Inner cell mass (ICM): these cells make the baby
- Trophoblast: these cells support implantation and help make the placenta
For genetic testing, we perform an embryo biopsy to remove some of the trophoblast cells from the blastocysts. The blastocysts are frozen until the genetic analysis for each embryo is completed.
The trophoblast cells are then prepared by our embryologist and shipped to a specialty genetic testing lab. The lab will already have information about the parents and their families in order to better identify the abnormal gene. At the lab, the cells are either tested for PGT-A (formerly PGS), PGT-M (formerly PGD), or both.
Doctors at our center will review the genetics report and, in consultation with the patients, advise which embryos are normal and available for embryo transfer.
What's the Difference Between PGT-A and PGT-M?
Preimplantation genetic testing for aneuploidy (PGT-A) provides information about the embryo’s chromosomes to detect Trisomy, whereas preimplantation genetic testing for monogenetic/single-gene diseases (PGT-M) looks for the presence of a specific, disease-causing gene such Cystic Fibrosis or Sickle Cell.
PGT-A
PGT-A tests embryos for the presence and the correct number of every chromosome. Over 90% of our IVF patients utilize PGT-A as a part of their treatment plan.
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Preimplantation Genetic Testing FAQ
Normally, human chromosomes have the following properties:
Chromosomes are numbered according to size (ex. Chromosome 1 is the largest) Cells in an embryo should contain a total of 46 chromosomes: two of every chromosome from 1 to 22 plus two X chromosomes (for females) or one X and one Y chromosome (for males).
Any variation of this, either an extra chromosome(s) or a missing chromosome(s), is an abnormality that can affect the ability of the embryo to live, grow, and/or implant when transferred.
In certain cases, the abnormality can be compatible with pregnancy and birth but will result in an affected child. Examples of this are: Down Syndrome: produced by the presence of an extra chromosome 21Turner’s Syndrome: caused by the absence of one of the X chromosomes in females
- An embryo with the correct number of chromosomes has a significantly higher chance of implanting in the uterus. This increases the success of IVF. It is also beneficial for women of advanced maternal age because women produce more chromosomally abnormal eggs as they age.
- Pregnancy loss is often caused by chromosomal abnormalities. PGT-A can identify embryos with a high risk of miscarriage.
- PGT-A can identify embryos with chromosomal abnormalities that are compatible with life but will produce an affected child.
In PGT-M, embryos are analyzed for the presence of a specific abnormal gene that can cause disease. This gene is known to be carried by the parents or present in the family of the parents.
There are many diseases caused by defects in single genes: hemophilia, spinal muscular atrophy, Tay Sachs Disease, Huntington’s Disease, cystic fibrosis, and sickle cell anemia are all examples.
PGT-M can identify specific embryos that are either affected by a defect in a single gene or are carriers of the affected gene. By avoiding the transfer of affected embryos, intended parents can ensure that children resulting from IVF are free of the disease that plagues their families.