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What are the advantages of Comprehensive Chromosome Screening (PGT-A/ CCS) for Advanced Maternal Age patients (+38)?

Dr Natalia Pylypenko
Оbstetrician-Gynecologist & Reproductive Specialist, ARTCLINIC

Category:
Advanced Maternal Age, Genetics PGS / PGT-A

COMPREHENSIVE CHROMOSOME SCREENING-ivfwebinars-ARTCLINIC
From this video you will find out:
  • What risks are associated with patients of advanced maternal age?
  • How does advanced maternal age impact the likelihood of chromosomal abnormalities in embryos?
  • What are the key advantages of PGT-A in terms of improving IVF success rates for women of advanced maternal age?

What are the advantages of Comprehensive Chromosome Screening (PGT-A/ CCS) for Advanced Maternal Age patients (+38)?

During this event, Dr Natalia Pylypenko, Obstetrician-Gynecologist & Reproductive Specialist at ARTCLINIC, discussed how PGT-A/CCS can enhance fertility options and ensure healthier pregnancies for women 38+. Dr Pylypenko explained the advantages and latest advancements of PGT-A testing.

Dr Natalia Pylypenko started her presentation by addressing the challenges of advanced maternal age, offering solutions such as fertility preservation,  egg donation, and mitochondrial donation.

The Aging process

Examining a biological phenomenon, consider women on the left, almost 35, and compare them to those on the right. Can we regulate hormonal changes in all cells? Mitochondria, with a potential longevity of 100 years, challenge previous notions about age’s impact on activity levels and parenthood.

Comparing women’s modern perception of age to past decades reveals a significant shift. Women in their 80s now symbolize vitality and self-realization. This reflects a growing awareness that challenges previous notions about the impact of age on activity levels and the ability to embrace parenthood.

Trends in motherhood

Observing trends since the early 20th century, women increasingly embrace motherhood after 35. This marks a societal shift in norms, accepting delayed motherhood. Yet, questions arise about age’s impact on outward vitality and the need for deeper pregnancy planning.

Advanced maternal age introduces complex landscapes of genetic anomalies, miscarriage, and pregnancy complications. Recognizing these challenges emphasizes the critical need for comprehensive care, strategic planning, and advanced medical intervention for the well-being of both mothers and infants.

Navigating fertility challenges, transformative options like egg donation, mitochondrial donation, and surrogacy emerge as beacons of hope. These advanced reproductive technologies offer tailored solutions, representing unique facets of the evolving landscape of assisted reproduction.

Genetic abnormalities in Advanced Maternal Age

Advanced maternal age increases the risk of genetic abnormalities like Down syndrome due to structural problems in eggs. Genetic testing becomes a crucial solution. Let’s explore the various types—PGT-A, PGT-M, and PGT-Sr—each serving distinct purposes.

PGT-A screens for chromosome abnormalities, PGT-M for specific single-gene disorders, and PGT-Sr for unbalanced chromosome rearrangements. Preparation varies, with PGT-A requiring none, PGT-M needing preparation, and PGT-Sr depending on the case under review.

PGT-A: A solution for Advanced Maternal Age?

PGT-A, or preimplantation genetic testing for aneuploidy, can be a solution for advanced maternal age. It provides information about embryogenetic health, aiding in selecting the best embryo for transfer and increasing the chances of a successful pregnancy.

Indications for PGT-A include advanced maternal age, recurrent implantation failure, and previous chromosomal abnormalities. The mechanism involves intracytoplasmic implantation, embryo biopsy, receiving results, selecting the best embryo, and preparing for transfer.

 

PGT-A offers several benefits, such as selecting embryos for transfer, increasing implantation rates, reducing miscarriage rates, avoiding amniocentesis, decreasing time to achieve pregnancy, and increasing the chance of a healthy baby.

Conclusion

In conclusion, knowledge is our guide, understanding is our strength, and we’re here to help you find the best solution for your path.

- Questions and Answers

Can you share your opinion about the non-invasive PGTA option? Have you been able to use it already?

This is still a new technique. We are not using it commonly, but for individual cases, we can discuss it with our patients if it is necessary. In the context of advanced maternal age, we have various options like IVF with own oocytes, egg donation, and surrogacy. To ensure 100% efficacy, PGT-A is the best testing method, increasing the implantation success rate by 8%.  

Why do not all embryos implant, and is PGT-A the solution?

For advanced maternal age cases with multiple embryos, specific protocols, like checking immunological status, can be applied. While PGT is an effective solution, it only increases implantation rates by 8%, leaving room for unsuccessful attempts. However, around 80-90% of our patients opt for PGT-A testing to boost their chances.  

Could there be any situation where PGT-A test result is inconclusive? What should be done in such cases?

Yes, there are cases with inconclusive results. In such instances, embryo transfer can proceed, but we discuss potential outcomes with the patient. If a positive beta HCG result follows, non-invasive prenatal testing becomes an option. Inconclusive embryos typically still have good morphology, making them usable, especially after unsuccessful transfer attempts.  

Can you tell us more about mitochondrial donation, and have you been involved in this experimental method?

Mitochondrial donation is an experimental method, but globally, around 60 babies have been born using this procedure, with the oldest being 7 to 8 years old. This option is suitable for advanced maternal-age patients with ovarian reserve. We have successfully employed this method for patients aged 45-51, achieving promising results.  

Is PGT-A recommended for egg donors every time?

In our experience, PGT-A is crucial for egg donors, as it ensures the best selection of embryos. Comparing results from donor cycles with IVF cycles, PGT-A significantly improves the chances of obtaining high-quality embryos. The necessity of PGT-A is discussed with individual patients based on their circumstances.  
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Authors
Dr Natalia Pylypenko

Dr Natalia Pylypenko

Dr Natalia Pylypenko - is an Оbstetrician-gynecologist & Reproductive Specialist since 2013. She is currently working at Artclinic, Ukraine. Dr Pylypenko focus is on advanced maternal age. She is a member of the International Menopausal Society, certified menopause specialist by IMPART.
Event Moderator
Caroline Kulczycka

Caroline Kulczycka

Caroline Kulczycka is managing MyIVFAnswers.com and has been hosting IVFWEBINARS dedicated to patients struggling with infertility since 2020. She's highly motivated and believes that educating patients so that they can make informed decisions is essential in their IVF journey. In the past, she has been working as an International Patient Coordinator, where she was helping and directing patients on their right path. She also worked in the tourism industry, and dealt with international customers on a daily basis, including working abroad. In her free time, you’ll find her travelling, biking, learning new things, or spending time outdoors.
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