Increase your chance of IVF SuccessPGT-A Preimplantation Genetic Testing for Aneuploidy (PGS 2.0)

What is PGT-A?

PGT-A, or Preimplantation Genetic Testing for Aneuploidy (PGS 2.0), is a type of genomic screening designed to improve the success rates of in vitro fertilization.

Embryos are screened for extra or missing chromosomes. The embryos that are found to be chromosomally normal (euploid) and the most likely to lead to a healthy pregnancy can then be identified for implantation selection.

Why is the number of chromosomes important?

Most cells in the human body possess 23 pairs of chromosomes, 46 in total. Chromosomes contain the genetic information that directs growth and development in the body.

23 chromosomes are inherited from the egg and 23 are inherited from the sperm.

When extra or missing chromosomes are detected, it’s called aneuploidy. Aneuploid embryos often develop improperly which makes them less likely to implant and more likely to miscarry.

We know that implanting an embryo with no chromosome abnormalities (euploid) into a healthy woman generally results in pregnancy, and the birth of a healthy baby. With the presence of identifiable chromosome abnormalities, especially those found in specific chromosomes, aneuploid embryos will have a high rate of failure to implant or may result in less than ideal pregnancy outcomes.

The benefits of PGT-A:

• Increased rate of successful implantation and pregnancy

• Reduced number of IVF cycles

• Decreased risk of miscarriage

• Increased chance of a healthy baby

What’s involved in PGT-A Screening?PGT-A screening is easily added to your IVF treatment plan.

PGT-A improves your chance of a successful pregnancy

When an embryo is in day 5 of development (blastocyst stage), your embryologist carefully biopsies a few trophectoderm (TE) cells for screening. TE cells are used because they develop into the placenta, NOT the fetus.

Access Genomics uses innovative Next Generation Sequencing (NGS) technology to analyze the sample cells and determine the genetic material present within each embryo.

PGT-A screening may reduce the number of IVF cycles necessary to achieve a successful pregnancy by identifying viable embryos for transfer.

0

0

zygote 2-cell stage 4-cell stage 8-cell stage 16-cell stage blastocyst

Day 0 Day 1 Day 2 Day 3 Day 4 Day 5

Is PGT-A right for me?

PGT-A can help all women increase their chance of pregnancy, however it’s particularly relevant to women with:

• advanced reproductive age (>35 yrs)

• experience of several unsuccessful IVF cycles

• history of repeated miscarriages

• known history of chromosome abnormality in both or either parent or in a previous pregnancy

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

<35 35-37 38-40 41-42

Implantation Rate (%) by maternal age

w/o PGT-A w PGT-A

w/o PGT-A: As we age, our embryos contain increasing genetic irregularities which cause the embryo implantation rate to decrease.

w PGT-A: Screening helps identify the genetically normal embryos and improves implantation rates.

PGT-A significantly increases chances of pregnancy

Next Generation Sequencing (NGS) Access Genomics uses the most advanced (2015)whole genome sequencing tool called Next Generation Sequencing (NGS).

NGS offers unrivalled depth of feedback in screening which empowers you and your fertility physician to make better informed decisions regarding embryo selection, which in turn may increase your chance of IVF success.

What is mosaicism?Mosaicism is a term for embryos that have levels of variants within one or several chromosomal strands. Depending on the levels of variants within the strands, mosaic embryos may still be viable for transfer.

Be informedThe detailed PGT-A reporting Acccess Genomics provides using NGS technology empowers you and your fertility physician to make better informed decisions for embryo selection and increases your chance of IVF success.

Genetic counselling availableCertain chromosomes do carry elevated risks, and if your only option is to transfer a mosaic embryo, then meeting with a genetic counsellor may help you make a more informed decision. Visit accessgenomics.ca for more information on genetic counselling services.

PGT-A is unanimously recommended by Canadian and International regulating bodies

The Preimplantation Genetic Diagnosis International Society (PGDIS) states that “Indeed, using these methods (preimplantation genetic diagnosis for aneuploidy, PGD-A, or preimplantation genetic screening, PGS) has now been shown in numerous studies to improve implantation, pregnancy and live birth rates (per embryo transferred) and reduce miscarriage rates.”PGDIS Newsletter, July 19, 2016 - PGDIS Position Statement on Chromosome Mosaicism and Preimplantation Aneuploidy Testing at the blastocyst stage.”

The Society of Obstetricians and Gynaecologists of Canada (SOGC) states that “Preimplantation genetic screening […] increases implantation rates and improves embryo selection in IVF cycles in patients ‘with a good prognosis’.”(Dahdouh et al., (2015) J. Obstet. Gynaecol. Can., 37(5):451-463).

A recent study on obstetrical and neonatal outcomes published by the American Journal of Obstetrics & Gynaecology (AJOG) states “By culturing embryos to the blastocyst stage, performing a trophectoderm biopsy, and amplifying DNA ... on each chromosome, a single euploid blastocyst with high reproductive potential can be selected for transfer. This paradigm eliminates the risk of multizygotic multiple gestation and increases the chance for a healthy, term singleton delivery without requiring patients to undergo an increased number of failed cycles. The improved obstetrical and neonatal outcomes suggest this approach may become the standard of care for infertile couples requiring IVF.”Eric J. Forman et al., February 2014, American Journal of Obstetrics & Gynecology, 157.e6

“A study performed at Reproductive Medicine Associates of New Jersey demonstrated that TE biopsy is safer than biopsying a single cell on day 3, and it’s also more accurate. A separate collection of cells called the inner cell mass (ICM) becomes the actual embryo, and ultimately the baby, and is not touched by the embryologist when TE biopsy is performed.”Eric Forman, MD, The Problem of Mosaic Embyros in IVF, https://www.fertilityiq.com/pgs-and-ccs-genetic-testing/the-problem-of-mosaic-embryos-in-ivf

By enhancing embryo selection with a validated method of aneuploidy screening, a single euploid embryo with high reproductive potential can be selected for transfer. Using this approach, eSET (elective single embryo transfer) can be performed without compromising delivery rates and improving the chance of having a healthy, term singleton delivery after in vitro fertilization.” American Journal of Obstetrics and Gynaecology 2014;210:157.e1-6.

2780 Slough StreetMississauga ON L4T 1G3 Canada

Tel 905.565.9495 Fax 905.671.1938accessgenomics.ca

Who we are

Access Genomics is Canada’s expert in fertility-focused genomics. We use the highest resolution platforms available for PGT-A, which means we can provide your fertility centre with the clearest, most reliable results available.

In order to offer you the latest, most effective and safe treatments and services, Access Genomics stays informed and connected with global leaders and innovators in genomics and genetic research and technology. For more research information on PGT-A, visit our resources section at accessgenomics.ca