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family balancing

Family Balancing
IHR provides highly successful IVF with preimplantation genetic testing treatment, also for gender balancing.

IHR provides highly successful IVF with preimplantation genetic testing treatment, also for gender balancing. Preimplantation genetic screening (PGS) is an advanced genetic test performed before pregnancy. Embryos obtained by IVF are tested for chromosomal abnormalities. Only the normal ones are transferred into the uterus for the woman to conceive with a healthy baby. PGD/PGS has been successfully applied at IHR as a clinical service for over 10 years now for over 1000 IVF-PGD/PGS cycles resulting in hundreds of healthy children born. While our primary goal is to assist the patients to conceive with a healthy baby, and since the sex chromosomes are part of the genetic test performed, we can offer gender balancing to those that are interested in it.

Even though each embryo has a 50% chance to be male and a 50% chance to be female, some families have more children of one gender. Gender selection for Family balancing can help these couples to have a child of the underrepresented gender in their family. It is important to understand that because of embryo’s chromosomal abnormality, lack of development to the blastocyst stage, or random distribution between female and male embryos, you have may not get the gender of your choice with one IVF-PGS cycle, and you may need to repeat such treatment. IHR's expertise in gender selection lies in our willingness and ability to individualize our approach to best suit each and every one of our patients. If you have any questions as you review the material on gender selection, please contact us for a FREE Family Balancing E-Mail Consultation.

Prior aneuploidy testing and gender selection involved analysis of a single cell from day 3 embryo by fluorescence in situ hybridization (FISH), using probes for a limited number of chromosomes. FISH testing is able to detect the most common chromosome abnormalities, including Down syndrome, Trisomy 18, Trisomy 13, and sex chromosome anomalies, in order to reduce the risk of having an affected child. Gender is determined by our sex chromosomes. FISH probes for X and Y are used to determine the gender of each embryo. A normal cell should show two FISH signals (or lights) for the numbered chromosome, and either two X signals for a female, or one X and one Y signal for a male.

However, recent data shows that abnormalities involving any chromosome can increase the risk of miscarriage and reduce the effectiveness of IVF. IHR’s new 24-chromosome testing is able to analyze the entire chromosome complement of a single cell, reducing the risk of failed implantation and miscarriage, and increasing the chance of having a healthy baby. Recent prospective randomized trials showed that when embryos are biopsied at the blastocyst stage (day 5-6), frozen, tested by PGS for 24 chromosomes, and transferred few weeks later after thawing, embryo implantation and delivery rates are actually improved significantly.

IHR offer 24-chromsome analyses using a technique called microarray, or array comparative genome hybridization (a-CGH). This technique compares the amount of DNA present for each chromosome in a single cell, and compares it to that of a normal standard. Microarray can be performed on blastomere (from Day 3 embryos), or trophectoderm cells from a blastocyst (Day 5-6 embryos). Embryo transfer during the same cycle is feasible for blastomere testing, whereas trophectoderm testing typically requires embryo freezing and thawing for transfer at a later date. With today freezing technology, outcome of frozen-thawed embryo transfer is as good or even better than of fresh transfer. The genetic counselors are available to provide comprehensive consultation, to assist you to choose which strategy is best for you, and interpretation of the PGS results. Biopsy on day 3 embryos (6-8 cells) can be performed, but is now considered less optimal. Trophectoderm biopsy on day 5-6 at the blastocyst stage (embryo with 70-80 cells), seems to have no significant short-term or long-term impact and may be used safely for embryo biopsy without notably reducing the pregnancy and delivery rate.

It is important to remember that like in any test in medicine, misdiagnosis may unfortunately occur. The error rate of PGD is nevertheless very low and is at less than 1%. During the genetic consultation about PGD that each patient will undergo, the specific strategy for the PGD test for this couple will be discussed, including possible rare risks and complication, and the limitations of the techniques. The IVF doctor will consult you on the IVF process, and possible risks and complications of the ovarian stimulation, medications used, procedures, multiple pregnancy, and outcome. The experience of the IVF doctor and center with patients coming for IVF with PGD/PGS may affect the outcome.

IHR has treatments for a variety of conditions, including gender selection, unexplained infertility, ovulatory dysfunctions, endometriosis, immunological infertility and many others. Perhaps less known is our work with individuals and couples who are considering assisted reproduction, but who are uncertain of their next step. We encourage anyone, before they make a decision, to consult with us. Currently, we are offering a FREE Family Balancing E-Mail Consultation.