Advanced maternal age is one of the biggest challenges for doctors as well as patients taking infertility treatment. Women who are past their mid-thirties normally find it hard to conceive due to low ovarian reserve. Research has established that there is steady decline in both quality and number of eggs as the woman ages. Most IVF clinics in Delhi opt for aggressive approach while treating such patients.
IVF is seen as the feasible solution for them because the procedure offers a considerably high success rate. Also, it yields results fast and time is very important when a woman’s biological clock is ticking. But IVF alone is not the way out; the reason is that there high risk of chromosomally abnormal baby for older women. IVF clinics in Delhi suggest pre-implantation genetic screening (PGS) to be used in conjugation with IVF to eliminate this risk.
PGS and Older Moms
As the name suggests, pre-implantation genetic screening is the screening of embryos before they are transferred into the uterus. The purpose is to pick out only the best and chromosomally normal ones for implantation. The procedure involves extracting one or more of the embryonic cells for rigorous chromosomal check. It is a delicate one, with risks of embryonic damage involved. Therefore, it is important to justify the test to ensure that its benefits are greater than the risks.
Normally, there are 23 pairs of chromosomes in humans; a number greater or lesser indicates chromosomal abnormality. For instance, Down syndrome is indicated when an extra chromosome 21 exists in the embryo. Chromosomally abnormal IVF embryos have a poor rate of implantation as well as are at higher risk of miscarriage. Perhaps, this is nature’s way of keeping check on the number of abnormal babies born.
It is to be noted that almost half of the IVF embryos are chromosomally abnormal. Maternal age is the main parameter which affects the abnormality rate. This happens because the eggs of older females show a significantly high rate of chromosomal anomalies. The question that IVF clinics in Delhi come across is whether PGS for older women is the best way out. For a better understanding, it is important to study chromosomal abnormality in relation to maternal age.
Chromosomal Aneuploidy and Maternal Age
Chromosomal Aneuploidy is a condition whereby eggs with extra/missing chromosomes result in genetically abnormal embryos after fertilization. Monosomy refers to missing chromosomes while trisomy indicates extra chromosomes. Such embryos fail to attach to the uterine wall and if they do, they may not develop to full term. In many cases, chromosomal aneuploidy may result in full time birth, but the baby might be physically and mentally challenged.
The risk of chromosomal aneuploidy increases with advancing age as the eggs grow older too. As the woman ages, her eggs lose their ability to divide properly. Consequently, they may have missing or extra chromosomes. This results in lower rate of IVF implantation in older women as well as higher miscarriage risk. Sadly, the number of abnormal babies is also higher for older mothers.
For these reasons, IVF clinics in Delhi see women of advanced maternal age as candidates for PGS. Similarly, those with multiple failed IVF cycles are suggested to opt for the screening, even if they are younger. PGS can actually help “weed-out” the chromosomally abnormal embryos and transfer the ones that have best chances of survival. For instance, an IVF treatment cycle has generated 5 embryos out of which 4 are abnormal. With PGS, the one that is chromosomally healthy is separated and transferred for best chances of IVF success.
PGS-Weighing the Risks and Benefits
PGS segregates the chromosomally healthiest IVF embryos for selective implantation. It improved the implantation rates, reduces risk of miscarriage and increases the chances of having a healthy baby. Such embryos can be used immediately for an IVF cycle or frozen for later use (preferably for younger women). At the same time, there is always a small risk of accidental embryo damage during micromanipulation biopsy. Similarly, there are remote chances of misdiagnosis too, when a normal embryo may be discarded as an abnormal one.
The patient needs to weigh the risks and benefits of PGS before deciding whether it is the right option for them. It is the responsibility of their specialist to guide them while taking this crucial decision. The expertise and experience of the embryologist is a key factor to ensure the success of the procedure. Therefore, it is important to seek treatment only from a reliable IVF clinic in Delhi.
At the same time, advancement of medical techniques has also brought down the embryonic damage risk to a considerable extent. These days, the embryo biopsy is done as it reaches the blastocyst stage (day 5-6 of culture). It is known as trophectoderm biopsy, as cells are taken from the trophectoderm, which later becomes the placenta. At this stage, the embryo has reached nearly 100 cells, out of while only 5 are to be removed for testing. This hardly weakens the embryo and also gives a better idea about the embryo’s genetic condition.
Gaudium IVF is a renowned IVF centre in Delhi, where patients can avail the best in advanced reproductive treatments. The clinic also offers high-tech diagnostic techniques to increase the chances of healthy and successful pregnancy. Contact here for free second opinion from Dr Manika Khanna, the top infertility specialist in Delhi.