In-vitro Fertilization (IVF) With Pre-implantation Genetic Screening (PGS) Helps Recurrent Pregnancy Loss Patients Reduce Risk of Additional Miscarriages

The world of reproductive medicine has always been filled with conflicting opinions and fascinating debate. One debate that is at the forefront at the moment relates to the subject of pre-implantation genetic screening, also referred to as PGS. PGS involves the analysis of cells of the embryo to ensure that the embryo has 46 chromosomes and not a different number. It was developed to enable embryologists to identify chromosomally normal (euploid) embryos for uterine transfer in an IVF cycle because only they can become healthy babies.

Points of view vary clinic to clinic about the appropriate usage of PGS in the IVF process. The lack of a consistent viewpoint has been a source of stress, complicating the decision-making process for the patient using IVF, which is already fraught with anxiety.

However, there is one circumstance in which there is widespread agreement among the medical community about the appropriate use of IVF with PGS. Literally every physician I have spoken with has expressed the view that IVF with PGS is an appropriate approach for women who have experienced recurrent miscarriages, provided that a specific cause has not been identified such as, for example, anatomic issues, thyroid or prolactin abnormalities, or chromosomal abnormalities in the parents (to name only a few).

It is generally believed that when miscarriage occurs and a cause has not been identifiable, the cause is most often chromosomal abnormalities (aneuploidy) in the embryo. The prevalence of these abnormalities increases with the age of the woman whose eggs are used to create the embryo. If the objective is to reduce the risk of miscarriage, chromosomally normal embryos can be identified through the application of PGS, provided they have been created. Once identified and transferred, the woman will be less likely to miscarry.

IVF with PGS has the ability to help the couple avoid another emotionally traumatic miscarriage. In addition, it helps the couple avoid the elimination of approximately 3 months out of the woman’s reproductive window as she will likely be advised that she should not immediately attempt to become pregnant again. In the older woman this is of particular concern, as her reproductive window has already narrowed and the delay before she can attempt another pregnancy may reduce her overall chance of ultimately achieving a healthy pregnancy.

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