PGD
Gender Selection (PGD) in Pakistan
Preimplantation Genetic Diagnosis (PGD) is a genetic screening process used in assisted reproductive technology (ART) to help increase the chances of a successful pregnancy. This technology screens embryos for chromosomal issues that may increase the risk of miscarriage.
PGD was first developed in 1989 by Dr. Alan Handyside to screen embryos for cystic fibrosis in IVF procedures. Initially, it was also used for sex selection, as male embryos carry a higher risk of certain sex-linked diseases. Over time, PGD has evolved to detect a wide range of genetic issues, including single-gene disorders and chromosomal abnormalities, making it a common procedure to help ensure the health of embryos chosen for implantation.
Process of PGD (Preimplantation Genetic Diagnosis)
Preimplantation Genetic Diagnosis (PGD) is performed following successful fertilization. Here’s an overview of each step in the PGD process:
Step 1: In-Vitro Fertilization (IVF)
This procedure is suitable for couples using assisted reproductive technology to conceive. IVF involves fertilizing a woman’s eggs with a man’s sperm, either naturally in a lab dish or through intracytoplasmic sperm injection (ICSI). After egg retrieval, the eggs and sperm are combined in a petri dish and left overnight for fertilization.
Step 2: Embryo Culture
The fertilized eggs are cultured in the lab for 3-5 days until they reach the blastocyst stage, where cells start dividing to form the fetus and placenta. At this point, an embryologist collects cells from the embryo for testing.
Step 3: Biopsy
In this stage, the embryologist performs a biopsy by extracting cells from the embryo and sending them to the lab for genetic diagnosis. The number of cells taken depends on the timing of the biopsy after fertilization, ensuring accurate test results.
Step 4: Genetic Analysis
The extracted cells are analyzed for chromosomal abnormalities and other sex-related genetic diseases. Diseased embryos are separated from healthy ones, with results available as soon as 2-3 days.
Step 5: Embryo Transfer
The final step in the PGD process is embryo transfer, where the healthiest embryo is implanted into the woman’s uterus through a minor surgical procedure. A pregnancy test is recommended within 10 days post-transfer. If positive, both the mother and embryo are monitored closely for health.
Applications of PGD (Preimplantation Genetic Diagnosis)
PGD is not a standalone fertility treatment but is used alongside fertility procedures like IVF to reduce the risk of chromosomal abnormalities, such as Down Syndrome, in children. Here are the key applications of PGD:
1. Choosing a Specific Gender
PGD allows parents to choose the gender of their child for two main reasons:
- Genetic Disease Prevention: Some genetic diseases are sex-linked, meaning children of a specific gender have a lower risk of inheriting them.
- Family Balancing: For family planning, parents may prefer a child of a particular gender. For example, if you already have a son, you may want a daughter for your next child. PGD assists in selecting an embryo of a specific gender for implantation.
2. Aneuploidy Testing
A typical embryo has 23 pairs of chromosomes, totaling 46 chromosomes. Aneuploidy, a chromosomal abnormality, occurs when there is an incorrect number or structure of chromosomes. This condition can lead to disorders like Down Syndrome and Turner Syndrome.
- Risk Factors: Although the exact cause of aneuploidy is unknown, it’s more common among older mothers and parents with a history of chromosomal abnormalities in previous pregnancies.
- Role of PGD: PGD screens embryos for these chromosomal irregularities, helping reduce the risk of such disorders before implantation.
1. Lower Risk of Chromosomal Abnormalities
With PGD testing, you can be confident that the embryo is screened for chromosomal abnormalities that may run in your family. This significantly reduces the likelihood of having a child with genetic disorders.
2. Higher Chances of Successful IVF
Chromosomal defects are a common reason for unsuccessful IVF attempts. By utilizing PGD, you can select the healthiest embryo for implantation, thereby improving the chances of a successful pregnancy and reducing the risk of pregnancy termination.
3. Family Planning and Balancing
For couples with a history of gender-associated diseases, choosing the gender of the child can be crucial. PGD enables parents to select embryos free from sex-related disorders, allowing them to choose the healthiest female or male fetus.
Preimplantation Genetic Diagnosis (PGD) is an excellent option for couples who have experienced multiple pregnancy terminations due to chromosomal abnormalities. Here are the key benefits of PGD for couples planning to conceive through assisted reproductive technology:
Benefits of PGD (Preimplantation Genetic Diagnosis)
What is PGD?
PGD (Pre-Implantation Genetic Diagnosis) is a procedure that assists couples in balancing their families by reducing the risk of passing hereditary genetic disorders to their children. Couples who already have at least one child of a specific gender often wish to have another child of the same or different gender.
What are the Steps in PGD?
Step 1: Initial Assessment and Counseling When a couple expresses the desire for family balancing or is assessed by their infertility specialist as being at risk of having a child with inheritable genetic disorders, they are advised to consider the PGD procedure.
Who Should Consider PGD?
Couples dreaming of a balanced family should consider PGD. This procedure allows parents to select the gender of their baby before embryo transfer and implantation, increasing the likelihood of having the desired gender.
Risks Involved with PGD
Most risks associated with PGD treatment are similar to those involved in intracytoplasmic sperm injection (ICSI) and in-vitro fertilization (IVF). These may include risks related to the procedures themselves, such as complications from egg retrieval and embryo transfer.
Common Considerations of PGD
One of the primary ethical considerations for Preimplantation Genetic Diagnosis (PGD) is embryo disposition. Since the procedure involves creating multiple embryos, some of which may carry chromosomal defects or be of a gender the parents do not desire, this raises significant concerns. Parents face decisions regarding whether to donate, freeze, or discard these embryos. Ultimately, among the multiple embryos created during IVF, couples typically choose the healthiest, leaving others—especially those with chromosomal abnormalities—unwanted and likely destined for disposal.
Advancements in PGD Treatments
Preimplantation Genetic Diagnosis has experienced several advancements that enhance fertility treatment outcomes, reduce miscarriage risks, and promote healthy pregnancies for couples facing infertility. Some of the notable technological advancements include:
1. Comprehensive Chromosomal Screening (CCS)
CCS is a significant advancement in PGD, as it detects chromosomal defects in embryos. An abnormal number of chromosomes can lead to disorders, such as Down Syndrome, making CCS essential for selecting healthy embryos.
2. Single-Cell Biopsy
This technique allows for the testing of individual cells within the embryo to analyze their genetic material. This method provides more accurate results while minimizing the risk of embryo damage.
Additionally, ongoing research is focused on improving PGD accuracy and gene editing methods. For example, CRISPR-Cas9 technology holds promise in eliminating gene defects, thus increasing the success rates of IVF and PGD. This technology enables precise modifications to the embryo’s genetic material by adding, removing, or altering DNA sequences.
Cost of Gender Selection in Pakistan
The cost of gender selection in Pakistan can vary based on the clinic and the specific procedure used, such as IVF with gender selection (PGD – Preimplantation Genetic Diagnosis) or sperm sorting. This cost typically includes the IVF procedure, genetic testing, and other related services. It’s important to consult specific clinics for an exact quote, as pricing can differ based on location, expertise, and the complexity of the case.
Australian Concept Medical Center offers advanced PGD (Preimplantation Genetic Diagnosis) services, a cutting-edge technique used for gender selection and genetic screening. PGD is part of the IVF process, allowing parents to choose the gender of their baby while also screening embryos for genetic disorders before implantation.
Conclusion
Preimplantation Genetic Diagnosis (PGD) is a vital option for ensuring embryo health before implantation into the woman’s uterus. While it may involve additional costs, PGD significantly reduces the risk of failed IVF attempts and increases the likelihood of a healthy pregnancy. Moreover, PGD plays a crucial role in gender selection and family balancing, making it ideal for couples seeking a child of a specific gender for personal or medical reasons.
