Why I Believe in Pre-implantation Genetic Screening (PGS)

pgs-imgIn a high quality fertility clinic, the most common reason why in-vitro fertilization (IVF) cycles fail is because the transferred embryos were aneuploid (chromosomally abnormal). The likelihood that this is the failure’s cause increases dramatically with the female partner’s age.

However, when a patient does IVF without pre-implantation genetic diagnosis (PGS) and the cycle fails, it is impossible for the physician to offer a precise reason for the cycle’s failure and, any reason offered is, in reality, speculation. Many of my clients have expressed frustration in response to their physicians’ inability to explain why their IVF cycles have failed.“Try again”, says the doctor. “You had back luck this time. If you keep trying you’re bound to succeed eventually.”

“IVF is an art rather than an exact science”, the patient is told. “I wish I could offer you a more fulfilling answer for why your cycle failed, but the world in which I practice medicine does not allow me to do that.”

These post-IVF failure discussions between doctor and patient are unsatisfying to the patient who longs with every fibre in her soul to have a child, and who, in most cases, is suffering (together with her partner, if she has one) under the weight of the extreme financial and emotional stress that comes with multiple IVF failures.

The physician’s inability to provide information about why the patients’ IVF cycles continuously fail often causes patients to enter the world of “self blame”. Here are some of the questions I have heard my clients ask themselves:

“Could it be my diet? Should I cut out dairy? How about wheat?”

“I was so stressed out at work during our cycle. Do you think I should quit my job?”

“Could it be my uterus? I am going to start looking into finding a surrogate.”

Some patients who experience multiple IVF failures are, in their vulnerability and desperation, also drawn to expensive, controversial and “last resort” therapies such as:

  • Lymphocyte immunization therapy (LIT), which theorizes that a woman’s body is not “baby friendly” because her immune system is defensive, and mistakes her partner’s sperm for a foreign invader or disease thereby preventing a successful pregnancy from occurring. When a woman undergoes this therapy she is injected with her partner’s blood cells on the theory that this will encourage her immune system to stop seeing her partner’s sperm as a foreign “disease”; and
  • Antibiotic therapies that theorize that many people have chlamydia in their bodies without knowing it and that this is often the cause of “unexplained infertility”. When a couple undergoes this therapy the woman is given antibiotics intravenously and a series of uterine washes infusing mixtures of antibiotics into her uterus. The male partner’s prostate is directly injected with antibiotics through his rectum.

Ironically, it is often the most research-oriented patients who are most likely to pursue these controversial treatments, because they are determined to unlock the mystery of why IVF is not working for them. I certainly do not judge them for turning to these contentious theories. The fact is that long ago, in my desperation to find an answer for why I was experiencing multiple IVF failures, I too considered both these treatments and even pursued them. Let’s just say it was not a good experience.

Through the combination of my experience and the experiences of my clients I have come to believe in PGS. PGS provides the patient with important information that helps them to resolve their struggle. In a perfect world PGS will identify a euploid (chromosomally normal) embryo for transfer resulting in the birth of a healthy baby. However, in some cases its outcome is not the one the patients were hoping for; they learn that all of the embryos they produced in that cycle were aneuploid. Even in these less than happy circumstances, at least there is information, which offers the patient the peace of mind to exit the world of “self-blame”, to stop chasing dubious and costly theories, and to either attempt another PGS cycle hoping that a euploid embryo might still be identified, or to consider alternative ways of building the family they so desperately long for in a more emotionally comfortable fashion. I believe in PGS because, with the information it provides, I have seen it enable patients to put an end to their soul crushing struggle with infertility, one way or another. I believe in PGS because putting an end to the suffering is a very good thing.

For more information about PGS, click here and here.



For more information about PGS, click here , here and here.

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