Preimplantation genetic diagnosis (PGD) and genetic testing for aneuploidy (PGT-A): status and future challenges

Romualdo Sciorio1, Luca Tramontano2, James Catt3

  • 1Edinburgh Assisted Conception Programme, EFREC, Royal Infirmary of Edinburgh, Edinburgh, UK.

Insights

Preimplantation genetic testing (PGT) has evolved significantly since its inception. This review clarifies preimplantation genetic diagnosis (PGD) and preimplantation genetic aneuploidy (PGT-A) and discusses current methodologies.

Area of Science:

  • Reproductive Medicine
  • Genetics
  • Embryology

Background:

  • In vitro fertilization (IVF) has resulted in over 7 million births globally since 1978.
  • Preimplantation genetic diagnosis (PGD) emerged in the late 1980s for genetic abnormality screening.
  • Preimplantation genetic screening (PGS), now PGT-A, evolved as an IVF embryo selection tool in the mid-1990s.

Purpose of the Study:

  • To differentiate between preimplantation genetic diagnosis (PGD) and preimplantation genetic aneuploidy testing (PGT-A).
  • To review current indications for embryo biopsy and genetic analysis in assisted reproductive technologies.
  • To discuss the advancements in methodologies for euploid embryo selection.

Main Methods:

  • Review of historical and current genetic analysis technologies used in PGT.
  • Discussion of embryo biopsy techniques and their impact on genetic testing.
  • Analysis of cytogenetic advancements enabling improved PGD and PGT-A.

Main Results:

  • Evolution from fluorescent in situ hybridization (FISH) to advanced cytogenetic methods.
  • Development of various technologies for identifying euploid embryos for transfer.
  • Improved efficacy of IVF cycles through targeted embryo selection.

Conclusions:

  • PGT-A aims to enhance IVF efficacy by selecting euploid embryos.
  • Advancements in biopsy and genetic analysis have refined PGD and PGT-A.
  • Understanding PGD vs. PGT-A is crucial for optimizing IVF outcomes.

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