What is Preimplantation Genetic Testing- Aneuploidy (PGT-A)?

Preimplantation Genetic Screening (PGT-A) is a test that examines chromosomal material of an in vitro fertilized (IVF) embryos before implantation. It involves removing one or more cells from an IVF embryo to test for numerical chromosomal abnormalities (aneuploidy). This screening method facilitates the selective implantation of embryos that have a normal number of chromosomes (Euploid Embryos).

Prevalence

One in two human preimplantation-IVF embryos are chromosomally abnormal.¹
Up to 40% of morphologically normal embryos harbor aneuploidies.²

[1] McCoy RC. Mosaicism in Preimplantation Human Embryos: When chromosomalabnormalities are the norm. Trends Genet. 33(7): 448–463 (2017).
[2] Harton GL, Munne S, Surrey M, et al. Diminished effect of maternal age on implantation afterpreimplantation genetic diagnosis with array comparative genomic hybridization. Fertil Steril.2013;100(6):1695–1703.

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What are the common conditions that PGT-A can detect?

Turner Syndrome
Klinefelter Syndrome
Down Syndrome
Edwards Syndrome
Patau Syndrome
Other trisomies and monosomies that increase the risk of implantation failure and miscarriage
Segmental Gain and Losses (>20Mb) in chromosomes which can lead to abnormalities in the embryo

Why do you need the PGT-A test?

Reduces the number of IVF cycles required to achieve a successful pregnancy. 73% pregnancy rate with PGT-A vs 36% without using PGT-A^$
Increases success rate for single embryo transfer
Reduces the likelihood of miscarriage due to Aneuploidies
Increases reproductive success rates in women above 35 years

$: Majumdar G, Majumdar A, Lall M, Verma IC, Upadhyaya KC. Preimplantation genetic screening for all 24 chromosomes by microarray comparative genomic hybridization significantly increases implantation rates and clinical pregnancy rates in patients undergoing in vitro fertilization with poor prognosis. J Hum Reprod Sci 2016;9:94-100

When can the PGT-A test be done?

After fertilisation when the embryo is 3 to 5 days old. At this stage, there are sufficient number of cells from which DNA can be isolated,thus ensuring success of the test. Mosaicism of Aneuploidies can be detected at this stage Vitrification (rapid-freezing) of embryos after biopsy also allows the clinician todetermine the optimum conditions for implantation

Who needs to get tested?

Couples undergoing IVF
Patients at any age who have repeated implantation failure or recurrent pregnancyloss while undergoing IVF
Women over 35 years old undergoing IVF
Couples with recurrent miscarriages
Positive history of chromosomal abnormalities in the family
Diagnosed carriers of chromosomal aberrations

Why Claria PGT-A is better?

Sequencing based PGT-A lead to higher resolution and detects segmental deletions and duplications
Robust sequencing technology that provides sensitive and replicable results
CAP proficiency testing passed
Inherent flexibility to suit your needs without any compromise on quality.
We provide end-to-end support: From site validation and embryo biopsy training, to result data interpretation, phenotype correlation and genetic counselling

What is the technology that Claria PGT-A uses?

Claria PGT-A is carried out using advanced Next- Generation Sequencing (NGS) technology

What are the advantages of NGS based techniques?

Rapid and convenient
Screening of all 23 pairs of chromosomes for abnormalities in one test
Able to detect greater than 20 Mb gains and losses in chromosomes
Higher resolution – 1Mb areas are analysed to provide data with high confidence
High sensitivity in detecting Aneuploidy (100 % sensitivity)
High specificity and accuracy (99.98% specificity)
Lower chances of test failure with NGS

Advantages of PGT-A by NGS vs. other screening approaches

Fluorescent In Situ Hybridisation (FISH)	Array Comparative Genomic Hybridisation (aCGH)	Single Nucleotide Polymorphism (SNP) Microarray	NGS
A largely manual process, highly skill/operator dependant.	Requires normal DNA for each sample to provide a comparison. A prolonged hybridisation step.	SNP array analysis of DNA, extracted from a cell population, cannot indicate the mosaicism within the sample.	NGS detects partial chromosomal gains and losses more precisely. NGS detects Aneuploidy and segmental imbalances at the same time.
Screening all 24 chromosomes at once requires a special probes set, requiring separate software at higher cost per sample.	Levels of mosaicism of 20% or less will not be detected.	Longer time needed to complete intended test.	NGS provides more accurate detection of mosaicism of the Trophectoderm cells from blastocyst biopsy.
Difficult to resolve chromosomal overlaps/split signals.	Relatively expensive.	Relatively expensive.	NGS offers reduced costs and enhanced precision. It allows parallel analysis for multiple embryos for a single patient. In a single run, samples from different patients can be analysed together as well.

Claria PGT-A workflow

What is Preimplantation Genetic Testing - Monogenic Disorder?

PGT-M, S is a diagnostic procedure to test the material collected from an embryo for the presence of specific mutations carried by one or both parents. This is carried out when one or both genetic parents has a known genetic abnormality. In PGT-M, S every test is prepared on a case-by-case basis.

What can Claria PGT-M, S detect?

X linked disorders
Single gene disorders

Who is Claria PGT-M, S for?

Carriers of X-linked genetic disorders
Carriers of single gene disorders
Couples who have a child/ children affected by a single gene disorder
Couples who have a family history of a single gene disorder

What are the benefits of PGT-M, S?

PGT-M, S can test for most single gene disorders
PGT-M, S allows the clinician to select embryos that do not carry the single gene disorder being tested for the implantation
By using PGT-M, S, the single gene disorder can be prevented from being passed on from one generation to the next