Preimplantation genetic diagnosis (PGD) is a reproductive technology used during an IVF cycle. PGD can be used for diagnosis of a genetic disease in early embryos before implantation or pregnancy. Each cell in our body has 46 chromosomes (23 from the father and 23 from the mother). The chromosomes are made up of a substance called DNA that contains our genetic information. Information is distributed in the genes and there are two copies of each gene, one originating from the mother and the other from the father.
Alterations In The Chromosomes That Cause Diseases
- Numerical alteration: This is an irregularity that affects the number of copies of a chromosome. The most well known example is the Down's Syndrome, in which there are three copies of chromosome 21 instead of two.
- Structural alteration: This is an irregularity in the structure of a chromosome.
- Monogenic diseases: These are genetic diseases caused by a fault or mutation in a single gene. Examples of these diseases are Cystic Fibrosis, Haemophilia, X Fragile Syndrome, Myotonic Dystrophy, and Huntington's Disease among others.
During pregnancy, there are two types of diagnosis to establish chromosomal and genetic alterations in the foetus:
PGD Is Recommended For
- Couples at risk of transmitting chromosomal alterations or monogenic diseases.li>
- Couples with a clinical history of repeated abortions or miscarriages.
- Implantation failure after several attempts with IVF.
- Alterations in the meiosis of the spermatozoa.
- Women of advanced age.
Vitrification delivers the same clinical results as with fresh eggs with a high survival rate of the oocytes.
Becoming A Mother After Receiving An Oncological Treatment.
Vitrification of oocytes is the most viable option for women who have to undergo chemotherapy or radiotherapy. However, it must be performed with the oncologists' consent.
- Creation of oocyte (egg) banks. Through oocyte donation, immediate oocyte availability is ensured.
- New possibilities in the clinical handling of different pathologies in assisted reproduction:
- Ovarian Hyper Stimulation Syndrome (OHSS): In OHSS, it is not advisable to carry out an embryo transfer in the same treatment cycle. Hence, vitrifying the eggs for insemination during a new cycle is an excellent alternative.
- When the oocytes do not respond adequately to stimulation and very few oocytes are obtained, we can accumulate oocytes from two or three stimulations. This will enable us to choose the best possible embryo for implantation in the uterus.
- In case a semen sample cannot be provided on the day of the oocyte retrieval, or if the sperm sample is of poor quality, the technique of vitrification is appropriate.
- Vitrification of the remaining embryos Once the embryo transfer has been done, the remaining embryos will be vitrified so that they may be transferred in a later cycle without the need for an ovarian stimulation.
Delaying Motherhood Through Cryopreservation
Delaying motherhood has become a trend owing to the socio-economic reasons and change in lifestyle. Egg cryopreservation provides the opportunity for these women to preserve their eggs until they are ready to be mothers or once they have attained professional and financial stability. Egg cryopreservation enables the creation of donor egg banks. It also provides an alternative in cases where the man finds it impossible to give his semen sample on the day of the ovarian puncture, or when it is necessary to delay the time of embryo transfer. For example, in cases where there is a risk of ovarian hyper stimulation syndrome...
A Blastocyst Is An Embryo That Has Developed For Five To Seven Days After Fertilization.
- It has two distinct cell types
- It has a central cavity filled with fluid (blastocoel cavity)
- Cells have started to differentiate
The surface cells that surround the cavity (just under the outer shell) later develop into the placenta and the more centrally located group of cells are called the inner cell mass, that develop into the foetus.
In a conventional IVF, the embryos are transferred to the uterus after 48 hours between the fourth and eight cell stages. In a natural conception, the embryo reaches the uterine cavity only on the fifth day. With the availability of an extended culture medium, we can culture the embryos in the laboratory till the blastocyst stage (i.e. fifth or sixth day). This procedure is called as blastocyst culture. With the blastocyst embryo transfer, we can transfer the embryos of a smaller number, while keeping the overall pregnancy rates high. This reduces the risk of multiple pregnancies.
Testicular biopsy involves examining the testes for sperm production. This is done for both, diagnosis as well as therapy. Diagnostic biopsy is done for men with azoospermia (no sperm in the semen) to know whether sperm is being produced or whether there is a failure of sperm production. Based on the results, further treatment is planned.
A therapeutic testicular biopsy is for men with azoospermia, to recover sperm from the testes. The sperm is then used for ICSI (test- tube baby).Testicular biopsy can be performed under general or local anesthesia. Previously, all biopsies were open surgery but now most of the biopsies can be done with a needle technique which is as effective as an open biopsy, but is associated with no pain or discomfort since there are no cuts or stitches on the testes.
If the testes are very small then open microdissection TESE is required in which the testes is opened and examined under a microscope for biopsy.
NFC offer all techniques of testicular biopsy – percutaneous (needle biopsy) and open microsurgical – based on the patient's needs.
Semen donation is a voluntary act through which a healthy male with a healthy quality of semen donates his gametes to be used by an authorized reproduction center for the purpose of achieving pregnancies in women. The donor is economically compensated for this activity. Management, control and supervision of this activity are carried out in the reproduction clinics that provide semen banks in their services offered.
Who Can Opt For Donor Help?
- Heterosexual couples with abnormal, few or a lack of spermatozoa.
- When the father may transmit genetic disorders or contagious diseases.
- Repeated failure in assisted reproduction treatment on using semen from the couple themselves.
- Women partners.
Who Are Semen Donors?
Donors are healthy volunteers of legal age, who undergo various check-ups to demonstrate a perfect state of health and sperm quality.