PGD/PGS treatment in Iran
What is the PGD?
Fetal health is always one of the concerns of parents during pregnancy. One of the factors that can threaten fetal health is the presence of genetic diseases in parents. Also, increasing maternal age can also increase the risk of chromosomal abnormalities in infants. There are various diagnostic methods like PGD for examining fetal chromosomal abnormalities. Some diagnostic methods evaluate fetal health after implantation and prenatal diagnosis is known as PND.
If you detect anomalies using these methods, it is very difficult for couples to make an abortion decision and can cause irreparable physical and psychological damage. However, some genetic diagnostics assess the health of the fetus before implantation and at the beginning of pregnancy, which is known as Preimplantation Genetic Diagnosis (PGD).
How is PGD done?
The first stage of PGD is in vitro embryo formation through IVF / ICSI infertility treatment methods. Laboratory fertilization embryos are cultured in the laboratory environment. After 3 to 5 days of fertilization, the embryo reaches a 6 to 10 cell stage.
At this stage, one or two cells are separated from the embryo by biopsy for genetic studies and tests. The DNA of the obtained cells is examined using specific techniques to evaluate possible genetic problems in the fetus. This process takes at least a week.
Separation of these cells may appear to interfere with fetal growth, but no worries, because the embryos are kept a little longer in the culture medium for regenerating to return to their normal growth. Genetic tests are also performed during this time. If the fetus does not have a genetic problem, it is ready for transfer to the uterus or freezing for subsequent pregnancies.
What disorders are diagnosed with PGD?
PGD can be used to diagnose many genetic diseases before pregnancy begins. Genetic disorders that can be diagnosed by the PGD method include:
Genetic diseases such as thalassemia, cystic fibrosis, muscular dystrophy, fragile X syndrome caused by mutations in a particular gene.
Some X-linked sex chromosome diseases such as Duchenne muscular dystrophy, hemophilia, fragile X syndrome, mental retardation, etc. are diagnosed using PGD. The use of PGD can prevent the transmission and birth of male fetuses that have a higher risk of developing these diseases.
Changes in the number of fetal chromosomes account for about 60% of all abortions. The PGD method helps to identify chromosomal abnormalities in terms of numbers and structure. The most common abnormalities in the number of chromosomes are present involving chromosomes 13, 18, 21 and X and Y.
Today, Preimplantation genetic diagnosis (PGD) methods can detect many genetic abnormalities before implantation in the uterus. Preimplantation diagnosis can prevent the described problems. Over 90% of chromosomal abnormalities can be identified using diagnostic techniques. But it must be remembered that some genetic diseases occur during pregnancy. Therefore, genetic testing does not completely eliminate the risk of the fetus developing genetic diseases.
What are the Benefits of Using PGD?
Using PGD along with in vitro fertilization methods (IVF or ICSI) can increase the chance of successful infertility treatment. Because:
- The fetus selected for transfer to the uterus is a healthy fetus.Therefore, it prevents the fetus from forming with genetic abnormalities or chromosomal abnormalities that may cause spontaneous abortion and recurrent miscarriages.
- To perform the PGD, one or more cells need to be removed from the fetus.Removal of the cells creates a hole in the fetal belt, which can be the starting point for better implantation of the fetus in the uterus.
Using PGD can be useful for parents who are prone to having a child with genetic diseases.
This procedure is done before implantation and allows parents to make the decision to continue the treatment process more easily. In addition in cases of unhealthy fetuses, PGD is important for people who, for legal, religious or ethical reasons, do not want to have an abortion. Because they can ensure the health of the fetus before the embryo transferred to the uterus and there is no need for an abortion anymore. One of the important advantages of using the PGD method is the possibility to study more than 100 genetic diseases in the fetus which can greatly guarantee fetal health.
When is PGD used?
Using the PGD method can be helpful for the people listed below:
- Couples who are at least carriers or suffering the inherited genetic disease.
- Couples who have undergone IVF or ICSI more than 3 times. But it did not lead to pregnancy. (IVF failure causes)
- Couples whose infertility is caused by a low sperm count. (Learn more about infertility in men: Causes of male infertility
- Couples who have no specific reason for their repeated abortions
- To detect the fetal sex in diseases such as hemophilia that is sex-dependent.(The Occurrence of these diseases is more common in boys than in girls).
- Single-gene diseases such as thalassemia that may occur in the baby
- Couples with a family history of genetic diseases such as Huntington’s.
- Couples who have a pregnancy history of chromosomal abnormalities
- Parents who have a child with a genetic disorder
- Parents who want to choose their child’s gender.
Sex selection by PGD method:
One of the uses of PGD is to determine the sex of the fetus before transferring to the uterus and pregnancy. Prenatal sex selection is performed both because of parental interest in particular sex and to prevent the transmission of hereditary genetic diseases.
Determining the gender of the fetus is a topic that every parent has been interested in from the past to the present. In developed countries, embryo sex selection is a technique used to select the sex of a child before fertilization.
There are couples who are more interested in a particular gender of a girl or a boy; Others are expecting a child of the opposite sex after having three or four daughters or sons but to no avail. Some couples also prevent the birth of a child with a genetic disease by determining the sex because of the genes associated with certain diseases.
PGD Genetic diagnosis before implantation can be used to diagnose the fetus. PGDs are the only method of gender selection that is nearly 100 percent accurate because it is performed before implantation of the embryo in the uterus. While this is the most accurate technique, it is also the most complex.
To determine sex by PGD, first, mature eggs are removed from the ovary during IVF treatment by an IVF specialist (puncture). After fertilization of the eggs with sperm in the laboratory, the embryo is formed. A cell is then isolated from the dividing embryo and subjected to genetic and chromosomal analysis. After determining the sex of the embryos, the fetus is transferred to the uterus by an infertility specialist. Examination of the fetus for some genetic diseases as well as the sex of the girl or boy was performed within 48 hours to transfer the fetus on time.
How successful is PGD in fetal sex determination?
So far, there is no definitive method for determining the sex of the fetus. But according to the latest statistics, using PGD is only 2 to 3 percent error in fetal sex determination. It should be noted, that, The PGD method is used to determine the sex of the fetus along with IVF or ICSI methods, and the chance of pregnancy in this method is between 30 and 40 percent.
What are the Concerns about Doing PGD?
Although, PGD is one of the most accurate methods of genetic diagnosis. But it cannot alleviate all the concerns about a healthy pregnancy. Some of the concerns in this regard include:
- Using the PGD method reduces the chance of a fetus becoming pregnant with genetic problems. But, it does not completely eliminate the risk of the fetus developing genetic diseases. More tests during pregnancy are needed to accurately diagnose the presence or absence of genetic disorders.
- Some genetic diseases occur during pregnancy. Therefore, the use of PGD cannot help diagnose all genetic disorders.
- Some people believe that embryo formation is the beginning of life and destroying the fetus, even with a genetic problem, is considered killing a person.
Can I use PGD?
You should consult your doctor about the age, history of fertility, and the use of assisted reproductive techniques as well as your genetics and family history.
If you are concerned about the transmission of genetic diseases to your child or suffer from infertility for unknown reasons or recurrent miscarriages or your infertility is due to male infertility factors, using PGD can be helpful. Also, mothers who are over 30 years old or have the failed IVF cycles are advised to use PGD in their next treatment efforts in addition to their treatment. In addition, if you are interested in a child of a particular gender, performing a PGD can help you choose the fetus that has the sex you prefer.
What is the difference between PGD and PGS?
Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD) methods can be used to detect genetic disorders in preimplantation embryos. Both of these methods are similar. But each one of them has a different purpose and is used to study different genetic problems. When there is no history of specific genetic problems, PGS is used to investigate possible genetic abnormalities in the fetus. But when there is a family history or specific genetic problem in the parent, the PGD method is used to screen for disorders that are most likely to develop in the fetus.
PGD in Iran
PGD is one of the most advanced techniques used in Infertility treatment centers in Iran to detect genetic abnormalities in embryos before transferring to the mother’s uterus and testing pre-fertilized oocytes.
PGD in Iran also is used for sex selection. PGD cost in Iran for sex selection is about 700$ for 4 embryos. For more than 4 fetuses, the cost of gender selection in Iran each fetus is about $ 120.
For more information about PGD and sex selection in Iran contact us through the free consultation page.