Genetic Screening and Embryo Selection in Surrogacy

With advancements in reproductive technologies, genetic screening and embryo selection have become increasingly significant in ensuring a healthy and successful surrogacy journey. In this blog post, we will explore the importance of PGS/PGD in surrogacy and how it contributes to the overall success of the process.

What is PGS/PGD ? 

PGS, or Preimplantation Genetic Screening, is a genetic testing technique used in the field of assisted reproductive technology (ART). It involves the examination of embryos created through in vitro fertilization (IVF) to identify any chromosomal abnormalities or genetic disorders. PGS provides valuable information about the genetic health of the embryos, allowing intended parents to select the most viable and genetically normal embryos for transfer during the surrogacy process.

On the other hand, PGD, or Preimplantation Genetic Diagnosis, is a similar technique that focuses on testing specific genes or genetic mutations associated with known genetic diseases or conditions. PGD allows the identification of embryos that are unaffected or carriers of the specific genetic condition of concern.

Both PGS and PGD offer intended parents a greater understanding of the genetic makeup of the embryos, enabling them to make informed decisions about which embryos to transfer, increasing the chances of a successful pregnancy and the birth of a healthy baby.

What is the Working Principle of PGS/PGD ?

PGS/PGD involves a series of steps that are performed in a laboratory setting. Here is an overview of how PGS/PGD is applied and its working principle:

• In Vitro Fertilization (IVF)

The surrogacy process usually begins with IVF, where eggs are retrieved from the intended mother or an egg donor and fertilized with the intended father’s sperm in a laboratory. This process results in the creation of multiple embryos.

• Embryo Development
• The embryos are allowed to develop in a controlled environment for several days. Typically, the embryos are monitored closely during this time to ensure their proper growth and development.
• Biopsy
• At a specific stage of development, usually around day 5 or 6, a small sample of cells is gently removed from each embryo for genetic analysis. The biopsy can be performed using different techniques, such as removing a few cells from the outer layer (trophectoderm) of the embryo.
• Genetic Analysis
• The collected cells from each embryo are subjected to genetic analysis using advanced laboratory techniques. PGS/PGD can involve different genetic testing methods, such as next-generation sequencing (NGS) or polymerase chain reaction (PCR), depending on the specific requirements and goals of the intended parents
• Genetic Evaluation
• The genetic analysis provides information about the chromosomal composition of the embryos or the presence of specific genetic mutations or disorders. This evaluation helps identify embryos with a normal chromosomal profile or those free from specific genetic conditions of concern.
• Embryo Selection
• Based on the genetic evaluation, the embryos that are deemed healthy and genetically normal can be selected for transfer into the surrogate mother’s uterus. The selection process aims to maximize the chances of successful implantation and a healthy pregnancy.
• Transfer and ImplantationThe selected embryos are transferred to the surrogate mother’s uterus through a minimally invasive procedure. If successful, the embryos implant into the uterine lining, leading to pregnancy. What Are The Advantages of PGS/PGD in the Surrogacy Process? 

  PGS/PGD offers several advantages in the surrogacy process, providing intended parents with valuable information and increasing the chances of a successful outcome. Here are some key advantages:

  • Enhanced Embryo Selection 

  PGS/PGD allows for the identification of embryos with a normal chromosomal profile or those free from specific genetic conditions. By selecting the healthiest and genetically normal embryos for transfer, the chances of implantation and a successful pregnancy are significantly increased.

  • Reduced Risk of Genetic Disorders

  PGS/PGD helps to minimize the risk of passing on genetic disorders to the child. By screening embryos for specific genetic mutations or conditions, intended parents can make informed decisions about which embryos to transfer, ensuring a higher likelihood of a healthy baby.

  • Increased Pregnancy Success Rates

  By selecting the most viable and genetically normal embryos, PGS/PGD improves the overall success rates of the surrogacy process. The transfer of healthy embryos with a higher chance of successful implantation leads to increased pregnancy rates and a lower risk of miscarriage.

  • Emotional and Financial Savings

  By reducing the risk of failed implantation or the birth of a child with genetic disorders, PGS/PGD helps intended parents save emotional distress and financial resources associated with unsuccessful pregnancies or raising a child with complex medical needs.

  • Peace of Mind for Intended Parents

  PGS/PGD provides intended parents with valuable information about the genetic health of the embryos. This knowledge allows them to make informed decisions, feel more confident about the surrogacy process, and have peace of mind knowing that they have taken steps to minimize the risk of genetic disorders.

  

  What are the Limitations and Considerations of PGS/PGD?

  There are several important points to consider when it comes to the limitations and considerations of PGS/PGD in the surrogacy process.These may include:

  • False Negative and False Positive Results
    PGS/PGD can produce false negative or false positive results during the genetic analysis process. False negative results may overlook the presence of a genetic disorder, while false positive results may classify a normal embryo as high-risk. Therefore, caution should be exercised in evaluating the accuracy of the results. 
  • Embryo Loss
    The PGS/PGD process carries the potential risk of embryo loss due to the embryo biopsy. There is a possibility that the removal of cells during the biopsy can impact the embryo’s development. Therefore, the decision to perform a biopsy for each embryo should be carefully evaluated. 
  • Limited Genetic Testing Capacity
    While PGS/PGD has the ability to detect specific genetic conditions, it may not encompass all genetic disorders or diseases. Some genetic disorders or rare genetic variations may not be detectable through PGS/PGD testing. 
  • Cost
    PGS/PGD may involve additional costs and time investment. The genetic analysis and biopsy process can increase the overall cost of the procedure. Intended parents should consider these factors and plan their budget accordingly. 
  • Ethical and Emotional Considerations
    The PGS/PGD process provides intended parents with the ability to select embryos based on genetic characteristics. This can bring about ethical and emotional challenges. Intended parents should consider the ethical dimensions of genetic selection and take into account their personal values.

  What Support Services are Available for PGS/PGD?

  Support services provided to intended parents during the PGS/PGD (Preimplantation Genetic Screening/Preimplantation Genetic Diagnosis) process are of great importance. By utilizing these support services and resources, you can enhance your PGS/PGD experience, feel more empowered in your decision-making process, and have the necessary support to navigate the challenges and emotions that may arise along the way.

  • Genetic Counseling

  Genetic counseling plays a crucial role in the PGS/PGD process. Genetic counselors are trained professionals who provide information, guidance, and support to individuals and couples undergoing genetic testing and embryo selection. They help explain the testing procedures, interpret the results, and assist in making informed decisions based on the genetic information obtained. Genetic counseling services are designed to address any concerns or questions you may have and provide you with the necessary support throughout the process.

  • Financial Guidance

  The financial aspects of PGS/PGD can be a concern for many intended parents. Seeking financial guidance and understanding the available options is important. Assistance programs, insurance coverage, and financial planning resources can help you navigate the costs associated with genetic testing and embryo selection. By exploring these options and creating a financial plan, you can alleviate some of the financial stress and make informed decisions about your PGS/PGD journey.

  • Surrogacy Agency Support

  Surrogacy agencies play a vital role in providing support throughout the PGS/PGD process. They can offer dedicated case managers or coordinators who will guide you through the necessary steps, answer your questions, and address any concerns. The agency will serve as a central point of contact, ensuring effective communication between all parties involved. Having a reliable support system in place can enhance your experience and provide reassurance as you navigate the complexities of PGS/PGD.

  • Additional Resources

  In addition to genetic counseling and emotional support, there are various additional resources available to support you during the PGS/PGD process. Educational materials, books, articles, and reputable websites can provide you with valuable information and insights into the genetic testing and embryo selection procedures. You can also seek referrals to trusted medical professionals and experts in the field who can offer specialized guidance and advice based on your specific circumstances.

  Conclusion

  Genetic screening and embryo selection, through techniques such as PGS/PGD, have revolutionized the surrogacy process, increasing the chances of a successful outcome. The ability to select the healthiest embryos for transfer not only enhances the prospects of a successful pregnancy but also reduces the risk of genetic disorders being passed on to the child. Overall, genetic screening and embryo selection in surrogacy have opened up new possibilities for intended parents, offering them a greater sense of control and peace of mind. With advancements in technology and the availability of support services, the surrogacy journey is becoming increasingly optimized and tailored to individual circumstances, fostering a greater likelihood of successful outcomes and the creation of happy, healthy families.