The quality of the embryo determines the implantation rate! Who should undergo PGT preimplantation genetic testing? Medical reveals the key to testing
The number of newborns has dropped by 32% in ten years! What is preimplantation genetic testing?
The phenomenon of low birthrate is becoming increasingly serious. According to statistics from the Ministry of the Interior, the number of newborns in Taiwan in 2023 will be only 135,500, a significant decrease of about 32% from 199,100 10 years ago. Doctors remind that as the rate of late marriage and late pregnancy among Taiwanese increases, female ovarian function and male sperm motility will deteriorate with age, increasing the risk of infertility. In addition to evaluating whether to accept artificial reproduction, if you have a late pregnancy, have experienced fetal arrest, or have had If you have a family history of genetic diseases, you can use preimplantation genetic testing (PGT) to increase your pregnancy rate and live birth rate.
Dr. Chen Junkai, director of Qixin Reproductive Center and the first Taiwanese doctor to complete medical training at the University College London PGD/PGS (PGT) Center, explained that preimplantation genetic testing involves culturing the embryos outside the mother for 5 to 6 months before implantation. day, the embryo at this time is called a “blastocyst”, and a small number of placental cells in the blastocyst (called “embryo slices”) are removed for screening to analyze whether there are chromosomal abnormalities. It not only improves the success rate of embryo implantation, but also reduces the risk of repeated miscarriage and increases the live birth rate of the fetus.
“In the early years, many couples worked hard to undergo in vitro fertilization, but faced fetal arrest after pregnancy. This was closely related to the unhealthy implanted embryos. In order to help infertile couples, I went to University College London (UCL) in 1997 to study preimplantation genetics. Testing, after being introduced to Taiwan, we have continued to improve culture technology and embryo slicing experience, allowing the embryo laboratory of Qixin Reproductive Center to achieve the highest success rate comparable to Europe and the United States, helping more groups in Taiwan who need artificial reproduction!”
30% of embryos under the age of 35 are still abnormal! The role of preimplantation genetic testing
IVF treatment has developed to the third generation. Dr. Chen Junkai pointed out that the first generation of IVF used sperm and eggs in a petri dish for fertilization and culture, and then selected beautiful embryos for implantation; the second generation of IVF used a single sperm microscope. Injections are of great help to patients with sparse sperm; third-generation test tubes are used to conduct chromosome or genetic screening of embryos before implantation.
Preimplantation genetic testing of embryos takes about several weeks. During this period, the embryos need to be frozen. Vitrification technology is used to rapidly cool down the embryos in an environment of -196 degrees C, which “pauses” all metabolism of the cells, except for providing Sufficient time to detect chromosomes can also preserve fertility in advance if necessary.
Dr. Chen Junkai explained that preimplantation genetic testing can detect important diseases related to chromosomal abnormalities, such as Down syndrome, Patau syndrome, Turner syndrome, Edwards disease, Klinefelter syndrome, etc. In addition, based on the genetic status of the couple and the genetic status of both parents, the embryo can be tested for hemophilia, thalassemia, ankylosing spondylitis, spinal muscular atrophy and hereditary hearing loss. If there are repeated abnormalities in chromosomal sites, it is necessary to suspect whether there is a chromosomal translocation, which may cause recurrent miscarriage or abnormal pregnancy.
“The quality of the embryo is related to the implantation rate, but even if the embryo is under 35 years old and has an AA grade, there is still a 30% chance of chromosomal abnormalities! It can be seen that if pre-implantation genetic testing is not done first, the embryo will be Fetal movement may stop halfway through development, causing a certain degree of damage to the woman’s uterus or psychology, so age is not the only factor to consider!”
Dr. Chen Junkai explained that clinically, blastocysts are graded “A, B, C” based on their appearance and placental cells. However, even embryos with “AA” grade cannot be diagnosed with chromosomal abnormalities based on their appearance alone. Preimplantation genetic testing can not only screen out embryos with the highest implantation rate, but also reduce the risk of repeated miscarriages. It is recommended that those who have had a history of fetal arrest, are at an advanced age at pregnancy, or have familial genetic diseases should seek early consultation as to whether they are suitable for preimplantation genetic testing.
Cross-border egg retrieval, but good embryos are rare! IVF pregnancy rate and live birth rate
“The success rate of in vitro fertilization is related to embryo culture and preimplantation genetic testing. A mother went to the United States for in vitro fertilization, but the number and quality of the embryos formed were not ideal, and she was never able to get pregnant. Later, she came to Qixin Reproductive Center The balanced translocation chromosome abnormality was just detected, and now we have successfully accumulated three good embryos, which are expected to be successfully implanted!”
Dr. Chen Junkai pointed out that the quality of the embryo affects the implantation rate, and the implantation rate directly affects the “pregnancy rate”, and the “live birth rate” refers to the probability of successful delivery after the embryo develops to full term. Embryos that have undergone preimplantation genetic testing have a higher chance of successful pregnancy for more than three months, and a relatively better live birth rate.
However, Dr. Chen Junkai reminded that preimplantation genetic testing is an invasive test, which may affect the chances of implantation of embryos with poor placental cells. The embryologist’s operating experience and laboratory environment may affect the testing process, and artificial reproduction is not possible. Beforehand, you should know whether the embryo culture environment and freezing technology of the reproductive medicine institution meet international certification standards.
One-shot, multi-shot friendly ovulation shot plus embryo slicing to realize your dream of having a baby? Doctors urge early fertility planning
Injecting ovulation injections is considered by many women to be the most difficult stage of IVF treatment. Dr. Chen Junkai said that many women indeed reported feeling stressed during the treatment process due to fainting from the injections, blood draws, or worries about administering the wrong dose of ovulation injections. However, Currently, there are ovulation-friendly injections that can cover multiple injections with one injection, which can significantly reduce the frequency of injections. If the ovulation response is good and combined with oral medication, there is a chance to further shorten the number of ovulation injections and successfully retrieve eggs.
“From the perspective of reproductive medicine, preimplantation genetic testing can increase the pregnancy rate and live birth rate. In modern society where late marriage and childbearing are common, preimplantation genetic testing is a very important second screening mechanism that can reduce future risks. The problem of miscarriage. As for the ovulation injection dosage form, there are already diversified options to help women more easily accept artificial reproductive treatment and reduce the intensity of return visits. Of course, the more important thing is to seize the golden fertility time and pay attention to your fertility status as early as possible! "
Dr. Chen Junkai reminds that environmental exposure and the use of plastic products may be potential factors for infertility. Whenever there may be fertility considerations, it is recommended to consult a reproductive medicine specialist as soon as possible. If women have menstrual changes after the age of 30, they should check the AMH egg inventory or plan to freeze eggs; men after the age of 30 should understand the health status of sperm and sperm motility. In particular, we are reminded not to believe in advertisements for “egg-raising” food, so as not to miss the golden opportunity to freeze eggs and retrieve them.
Dr. Chen Junkai suggests that before undergoing infertility treatment or artificial reproduction, you should consult a reproductive center with specialist doctors and embryologists to understand whether you need to undergo PGT testing to reduce the risk of repeated implantation failure, miscarriage or birth of a defective baby. The equipment and procedures of Qixin Reproductive Medicine Center are at the same level as the top reproductive medicine centers in Europe and the United States. The cyst-raising technology not only benefits Taiwan, but also has cooperative institutions around the world, helping many families in Taiwan and abroad successfully realize their dreams.
Further reading:
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