The Role of PGT-A In IVF

Embarking on IVF can feel like stepping into a world of complex medical jargon, endless decisions, and emotional uncertainty. One critical aspect often discussed by fertility specialists is chromosome health and its impact on your IVF success. Enter Preimplantation Genetic Testing for Aneuploidy (PGT-A).

Like any medical test, PGT-A might seem intimidating, but its core purpose is to identify embryos with the right number of chromosomes, maximizing your chance of pregnancy and minimizing the risk of miscarriage. But, what does it involve, and is it right for you?

Why Chromosome Health Matters

Each embryo carries genetic information, packed neatly into chromosomes. Normally, humans have exactly 46 chromosomes (22 pairs of autosomes and one pair of sex chromosomes XX or XY). Chromosomes are thread-like structures found within cells made of protein and DNA. DNA carries the genetic information from cell to cell. 

Embryos inherit 23 chromosomes from each parent, totalling 46. Embryos with the correct number of chromosomes are known as euploid embryos and are more likely to implant successfully and develop into healthy pregnancies.

Embryos with extra or missing chromosomes, or aneuploid embryos, often lead to implantation failure, miscarriages, or genetic disorders like Trisomy 21, or Down Syndrome. 

In some cases, the embryo has both euploid and aneuploid cells. Such embryos are known as mosaic embryos. 

PGT-A then becomes a great resource for identifying “unhealthy” embryos in order to avoid transferring them during an IVF cycle. 

What Does The Research Say?

Over the years, research has shown that embryo selection with PGT-A can improve pregnancy outcomes after initial embryo transfer. Nevertheless, it still remains uncertain whether PGT-A improves the cumulative live-birth rate when compared to traditional IVF.

Cumulative live birth rates refer to the percentage of IVF patients who will achieve at least one live birth following an IVF cycle. Cumulative live-birth rates in IVF with and without PGTA are are seen to be similar. 

Nevertheless,  PGT-A does improve implantation success rates, mainly because a tested embryo is more likely to stick than one that wasn’t tested. PGT-A distinguishes embryos with chromosomal abnormalities. Given that chromosomal issues are behind nearly half of first-trimester miscarriages, this kind of insight can be life-changing for many couples.

Even more, some experts believe that some PGT-A techniques are superior to others, but that’s not the case since no single technology currently reigns supreme.

Different fertility centers may prefer distinct methods, such as Next Generation Sequencing (NGS) or comparative genomic hybridization (CGH). The key isn't necessarily choosing one platform over another but rather ensuring your fertility team has experience and confidence in their chosen approach. Engaging in candid discussions with your specialist can help you navigate these nuances effectively.

Who Should Consider PGT-A?

Some clinics offer PGT-A during IVF, while others do not. Clinics that do PGT-A still ensure that you understand that the decision to use PGT-A is left up to you. Your fertility doctor will recommend PGT-A if you:

• Are over the age of 35
• Have faced recurrent pregnancy loss (RPL)
• Had a pregnancy or child with a genetic or chromosomal condition
• Have unsuccessful IVF cycles

Is PGT-A Always Beneficial?

Despite its clear benefits, not all clinics or fertility doctors recommend it. The American Society for Reproductive Medicine (ASRM) guidelines explicitly state that routine testing for every IVF patient isn't necessarily beneficial. Instead, PGT-A tends to be more valuable when it’s aligned with specific goals or individual circumstances, such as advanced maternal age or recurrent miscarriages.

For younger patients or those without a complicated fertility history, the benefits of PGT-A are less clear-cut. For example, cumulative live birth rates, which look at the chance of eventually achieving a birth through IVF, remain similar with or without PGT-A. However, what often changes is the speed with which pregnancy is achieved. This is because euploid embryos offer higher success per transfer.

Navigating Miscarriage Risks

If you've experienced recurrent miscarriages, you know the emotional toll is profound. Here, PGT-A could be particularly valuable. Research consistently supports using PGT-A to decrease miscarriage rates by ensuring the embryos transferred are chromosomally balanced.

With nearly half of early miscarriages linked to chromosomal anomalies, this targeted approach could dramatically improve your emotional and physical experience during IVF, fostering hope for those who've faced recurrent losses.

Speeding Up Pregnancy

IVF is not only an expensive affair, but it can also be emotionally exhausting and time-consuming. Any failed cycle feels draining. PGT-A can help reduce the time it takes to get pregnant by initially identifying the euploid or “healthy” embryos as they have the highest potential for successful implantation, pregnancy, and live birth.

Implantation Success

As already mentioned, there are different types of embryos, and those with genetic abnormalities can make implantation difficult. Sometimes, the embryo implants but fails to develop, leading to an early miscarriage. With PGT-A, a fertility clinic like Dallas IVF will be able to choose embryos that have all 46 chromosomes, increasing the likelihood of a successful transfer.

Offers A Better Chance For Aging Women

As women age, the percentage of embryos with chromosomal abnormalities also increases. And the older you grow, the higher the rate of “abnormal” embryos. PGT-A becomes a lifeline for such women, and can be the difference in ensuring the transfer of only the most viable embryos, making each cycle count.

Safety: Balancing Risk and Benefit

IVF can be overwhelming without the added risk of an embryo biopsy. The good news is the biopsy is generally safe, with minimal risk (1-5%) of harming the embryo. The embryos are typically frozen after biopsy, another step introducing a slight risk during thawing, though overall survival rates remain high.

Knowing these details can help balance the emotional and practical aspects of your IVF decisions, making informed choices easier.

Personalizing Your IVF Journey

Ultimately, incorporating PGT-A into your fertility journey is deeply personal. Your family-building goals, emotional resilience, and medical history all influence whether this testing aligns with your vision.

Engage openly with your fertility team. No question is too small. Your fertility team should help you understand how PGT-A fits into your specific fertility journey, empowering you to make informed, confident decisions tailored to your needs.

In a journey as personal and profound as fertility treatment, clarity and understanding are your most potent allies, bringing peace of mind as you move toward your dreams of parenthood.