While there have been several reports in the press in recent years about genetic disorders and IVF treatment, we felt that it was time that we put together an article that kept things in perspective. Although there is indeed an increased chance of some very rare genetic disorders such as Beckwith-Wiedemann syndrome being passed on, the chances are still incredibly low. When PGD (Preimplantation Genetic Diagnosis) which is now often referred to as PGT-M is used, the chances of passing on genetic disorders is massively reduced.
Indeed, we have found that an increasing number of patients are now enquiring about PGD in Bangkok. It can be used in conjunction with IVF, and often this is from couples who do not have any fertility issues. As a responsible fertility clinic in Bangkok, we are always conscious of ensuring that all of our patients receive the best possible advice so that couples where one or both partners may be predisposed to genetic disorders, IVF and PGD is an option we would discuss.
How do PGD and IVF help to reduce the incidence of genetic disorders?
PGD is an advanced procedure designed to assist couples who have genuine concerns that if they conceive a child, there is a higher chance that it may be born with either a genetic or chromosome disorder. PGD allows clinicians to analyse genes and chromosome looking for over 100 genetic conditions. Even if a couple potentially has an ailment that isn’t already commonly tested, a test could be designed specifically for that disorder. It brings immense comfort that there is hope for couples who had previously decided against starting a family.
How does the procedure work?
During the IVF treatment, the female will be given a cocktail of prescription medication designed to stimulate egg production artificially. Once egg production has reached optimal levels in the lead doctor’s view, the eggs will be harvested and taken to a laboratory. Around the same time, the male partner will be asked to provide a sperm sample, and this will be used to fertilise the eggs in a laboratory.
Once a blastocyst embryo has formed, a small sample of cells will be taken for analysis six days after fertilisation. It is at this point the PGD procedure commences. The analysis will be done in a genetic laboratory to check for a selection of genetic disorders. Any embryos that have one or more conditions will be removed, leaving only the healthy ones remaining. Depending on the number, of the healthy embryos, some or all will be implanted back in the womb of the female, thus significantly reducing the possibility of a genetic disorder being passed on.
Who is suitable for this form of Assisted Reproductive Technology (ART)?
PGD and IVF, in this case, would be suited to couples who believe that they have a higher chance than usual of being a carrier of a genetic disorder. In this instance, it would include carriers of sex-linked, single gene and translocations disorders. Indeed, as touched upon, a feasibility study could be conducted for couples who feel there is an increased likelihood of another hereditary condition that is not already being tested for being passed on to the child.
IS PGD infallible, and are there any risks?
Like almost all medical treatments, PGD does not carry 100% success rates which means that it is impossible to promise couples that their child won’ be born with a genetic disorder. However, it does significantly reduce the chances, but several points are worth considering before you embark on the course of treatment.
- It is impossible to test for all genetic disorders
Although PGD is used to test for over 100 known genetic disorders, many aren’t commonly tested for. There are many reasons for this, including the chances of the disorder being passed on are incredibly slim and therefore, to carry out this test is not viable. Also, the cost of testing for all known conditions makes it unfeasible, or that the genetic disorder order isn’t yet known about or an approve test hasn’t been designed.
- Parents may be unaware if they are carriers
Some potential parents, whether deliberately or not, maybe unaware if they are carriers which can complicate the issue. A disorder which patients frequently asked to be tested for is Huntingdon’s Disease where, in the past, an individual did not want to know whether they had the condition. However, they may wish to stop their child from getting the disease. In this case, testing is more complex as the “at risk” parent’s status is unknown.
- In rare cases, more than one course of IVF treatment may be needed
As a professional fertility clinic, we always explain to patients that they may require more than one IVF course. In very rare cases, all tested embryos may return “affected” results meaning that there would be a higher risk of the baby developing the disorder. Unfortunately, this will inevitably mean additional cost for the parents as well as increasing the emotional strain. Some would-be parents decide not to continue treatment in these cases.
- Developing unique tests takes time
All PGD tests are unique and must be developed on an individual-family basis, requiring significant amounts of work in the laboratory prior to testing. Even for more common conditions such as sickle cell or anaemia cystic fibrosis, it generally takes over a month for the test to be prepared. For less prevalent disorders, it can take significantly longer or may not be possible at all – something that is, of course, heartbreaking news for families.
In infrequent circumstances, IVF alone may increase the chances of a genetic disorder being passed on to a child. However, it should be stressed that the possibilities are extremely low. More often than not, PGD is used in conjunction with IVF to reduce the chances of a disorder being passed on to the child. Of course, it doesn’t eliminate the possibility, but it does significantly reduce it. Therefore, to conclude, babies can have a genetic disorder after IVF, but the chances are slim if PGD is used.