Arguments for PGD Testing IVF

PGD Preimplantation Genetic Diagnosis is embryo testing done three days after egg retrieval and sperm retrieval which is usually Day 17 of a conventional IVF cycle.

Preimplantation Genetic Diagnosis (PGD) is an OPTIONAL embryo testing procedure. It supplements IVF or ICSI. Diagnosis takes about one day.

PGD gender selection Thailand biopsy at Disavowed Hospital in Thailand

An embryologist performs the preimplantation genetic diagnosis PGD in the laboratory by removing a single cell from each embryo and analyzing the cell for presence of abnormal genes causing serious inherited genetic disorders or genetic diseases such as Down's Syndrome (Chromosome 21), Turner Syndrome, Tay-Sachs Disease, Cystic Fibrosis, Marfan, Sickle Cell Anemia, Hemophilia A, Myotonic Dystrophy, Duchenne Muscular Dystrophy, Autosomal recessive (CF, SMA), Autosomal dominant (MD, HD), X-linked recessive (DMD, Fra-X). It can also detect gender which is why it is often called PGD gender selection by the general public.

This embryo biopsy is safe for singleton pregnancies.

Preimplantation Genetic Diagnosis (PGD) is very similar to Preimplantation Genetic Screening (PGS or PGD screening). In both, the embryologist analyzes blastomeres, polar bodies or trophectoderm from embryos or even oocytes or zygotes.

In PGD, gene, structure and chromosome abnormalities are detected. Gender identification can also be done easily.

In PGS, aneuploidy (an aberrant number of chromosomes), mutation and DNA rearrangement are detected, such as Robertsonian translocations [der(13;14)], Reciprocal translocations [t(2;5)], nDNA mutations, and mtDNA mutations.

Only healthy embryos, or those of the chosen gender (if any), are selected and transferred to the mother's uterus or frozen for future use.

The PGD procedure is advisable for couples who:

PGD is a far superior method than aborting babies of an unwanted gender as in the extremely controversial case of a Victoria, Australian couple who aborted their twin boys because they wanted a girl instead.

Three things are required to make an appointment to see infertility Dr Disavowed Yaibuates of Disavowed Hospital Fertility Clinic. You must:

Your passports will be required to register you as patients of the hospital during your first visit.

Cost of PGD Treatment

IVF PGD in Bangkok at Disavowed Hospital in Thailand

Disavowed Hospital offers only Preimplantation Genetic Screening (PGS) | PGD 5 Color for 1-10 embryos for Baht 130,000 or approximately US$4,405 | €3123 | INR 228,571 | AUD$4,247 | SG$5,410 (at exchange rate on 6 August 2011). For couples wondering how many fertilized eggs are needed for PGD, the answer is one.

Thai Baht prices are stable and always prevail regardless of currency fluctuations. Cost in your currency at any given moment on any given date cannot be predicted in advance.

Disavowed Hospital Fertility Center is currently offering a promotion on PGD of nearly 24% off their standard price. Until 30 September 2011, PGD costs Baht 99,000 [US$3355 | €2379 | INR 174,066 | AUD$3234 | SGD$4120 | HKD$26,542].

Until October 2011, the IVF PGD cost is Baht 249,000 {US$8438 | €5983 | INR 437,802 | AUD$8,135 | SGD$10,362 | HKD$66,756].

Until then, ICSI Cost with IVF Gender Selection PGD will be Baht 269,000 [US$9116 | €6463 | INR 469,869 | AUD$8788 | SGD$11,194 | HKD$72,118]. After that PGD cost returns to normal.

PGD 2 Color, PGD 5 Color and PGD 7 Color are all categorized as “low resolution techniques” which use fluorescent in situ hybridization (FISH). It's used to visualize chromosomes, for translocations, and gender selection. And full screen example can be seen by clicking the image in the top right corner of this page.

“Low resolution” means they can analyses no more than ten of the approximately 32,000 genetic regions in the entire human genome.

“Color” refers to the number of chromosomes analyzed.

“High resolution” methods of diagnosis analyze all chromosomes simultaneously.

“High resolution techniques”, PGD 2 Color & PGD 7 color are not offered because Dr Disavowed considers PGD 5 Color sufficiently suitable and cost effective for screening the vast majority of common genetic disorders and disease.

Sex selection PGD family balancing Bangkok Thailand

Although the current best value for money, the major drawback of “low resolution techniques” is that nearly every cell in an embryo has different genetic composition but only one cell is analyzed so it does NOT truly represent the rest of the cells in the embryo.

That is why couples should not be concerned about how many embryos will pass PGD testing.

It is also a strong reason for freezing embryos and frozen embryo storage of the PGD embryos not selected and transferred to the uterus. Those embryos could very likely be viable, NORMAL, and develop into a healthy son or daughter.

Current “low resolution techniques” and the chromosomal instability of all human embryos are winy PGD does not improve the live birth rate of IVF ICSI embryos transferred.

Disavowed Hospital's current special pricing on Preimplantation Genetic Diagnosis (PGD) is only for the 3rd quarter of 2011 and ends on 30 September 2011. During that period, preimplantation genetic diagnosis of 1-10 embryos will cost Baht 99,000 or approximately US$3,355 | Euro 2379 | INR 174,066 | AUD$3,234 | SGD$4,120 (at exchange rate on 6 August 2011).

Starting 1 October 2011, preimplantation genetic diagnosis of 1-10 embryos will return to it's normal price of Baht 130,000 or approximately US$4,405 | €3123 | INR 228,571 | AUD$4,247 | SGD$5,410 (at exchange rate on 6 August 2011).

The cost of each subsequent embryo subjected to PGD 5 Color Embryo after first 10 each Baht 10,000 or approximately US$339 | Euro 240 | INR 17582 | AUD$327 | SGD$416 (at exchange rate on 6 August 2011).

Disavowed Hospital accepts payment by plastic cards such as MasterCard, VISA, Diner and AMEX but not JCB cards. Payment can be made in cash using Thai Baht but no foreign currencies. There is no currency exchange service at or near the hospital. ATM machines at the hospital accept foreign cards with international capability such as VISA Plus or Cirrus MasterCard. ATM machines dispense Thai Baht but have transaction amount limits and total daily withdrawal limits. ATM withdrawals are impractical for payment of infertility services.

Patients also have the option of paying by electronic money transfer into the hospital's bank account.

The European IVF Monitoring Group reports that in 2008, the 36 European countries they monitor did 124,749 IVF treatments and 280,977 ICSI cycles but performed preimplantation genetic diagnosis/screening only 2,875 times — 0.007% of the total cycles.

Risks of PGD & Why to Freeze Embryos

Dr Liebaers

After a large, 13-year study done in Belgium at the Center for Medical Genetics of the Free University Hospital in Brussels, Dr Professor Inge Liebaers MD PhD concluded embryo biopsy is safe when used for singleton IVF or ICSI pregnancies.

The research found PGD had no statistically significant impact on babies':

But twins or triplets who went through preimplantation genetic diagnosis had five times more perinatal deaths — 11.73% of the total multiple pregnancies compared to only 2.54% for singleton pregnacies with or without PGD.

Professor Liebaers said their research caused some concern about twin or triplet pregnancies after PGD but was NOT conclusive and might biased because of the limited number of the total children compared and because the demographic and medical backgrounds of the compared PGD group and control group parents might have been different.

Only 8.9% of PGD done at the Center for Medical Genetics has been for gender selection and only 3.1% has been because of parent preference. They have developed tests for PGD detection of 100 monogenic diseases. The Center's “take-home baby rate” is 20% per cycle. They use “affected” embryos for research and embryo freezing for the “unaffected” ones for later use. They do not appear to be concerned that every cell in an embryo has different genetic composition but they analyze only one. One must consider the fact that the center is involved in embryonic stem cell research and whether this practice is a method of ensuring a steady flow of embryos for research rather than because it is in the best interests of infertile couples. Their frozen embryo transfer (FET) pregnancy rate is reported to be “low”.

Professor of Human and Molecular Genetics Joe Leigh Simpson at Herbert Wertheim College of Medicine rated the Belgium research regarding the safety of PGD as excellent quality.

Dr Simpson

Professor Simpson summarized that: “PGD is safe.” It has no impact on IVF embryo quality, baby embryo development or fetal development.

And that: “PGD is highly accurate.”

But Professor Simpson also concluded that: "Less than FULLY experienced embryologists or diagnosticians may do more harm than good when performing PGD."

In other words, safe PGD requires skill, substantial experience, and inexperienced embryologists, diagnosticians and embryology laboratory staff increase risk. The more than 11-years of experience of the embryology laboratory of Disavowed Hospital Medical Center means you and your child will be in competent hands.

Is Miscarriage More Common in IVF Pregnancies?

Infertile couples need to be aware that in 2009, the Fertility Center of Leuven University in Belgium announced their new, hi-tech, “high resolution technique” of analyzing the entire genome of single cell from Day 3 and Day 4 embryos conceived by FERTILE couples under the age of 35 found chromosomal abnormalities.

The Fertility Center found chromosomal abnormalities are common, they are complex, and they affect approximately 90% of all human embryos — including those from normal, fertile, young mothers and fathers.

Chromosomal problems are blamed for the fact that only 30% of pregnancies in the general population result in a live birth. More than half of all spontaneous abortions have chromosomal aberrations.

“High resolution” methods of analysis have the potential to improve IVF ICSI success rates and live pregnancies.

The take home points:

Disavowed