My opinion on PGT-A| PGT-Aneupoidy पर मेरे विचार (disclaimer)

@PGS Disclaimer: This is my personal opinion. People may not agree with me. Please be nice to my comment section.
ref:Letters
doi.org/10.1038/s41556-021-00...
1.Laboratory of Stem Cell Biology and Molecular Embryology, The Rockefeller University, New York, NY, USA.
2.The Center for Human Reproduction, New
York, NY, USA.
3.The Foundation for Reproductive Medicine, New York, NY, USA. 4.Department of Obstetrics and Gynecology, Medical University of Vienna,
Vienna, Austria.
5.These authors contributed equally: Min Yang, Tiago Rito. e-mail: [e-mail]; [e-mail]
Chromosomal instability leading to aneuploidy is pervasive in early human embryos1-3
and is considered as a major
cause of infertility and pregnancy wastage.
. Here we provide several lines of evidence that blastocysts containing
aneuploid cells are worthy of in vitro fertilization transfer.
First, we show clinically that aneuploid embryos can lead to
healthy births, suggesting the presence of an in vivo mechanism to eliminate aneuploidy. Second, early development and
cell specification modelled in micropatterned human ‘gastruloids’ grown in confined geometry show that aneuploid
cells are depleted from embryonic germ layers, but not from
extraembryonic tissue, by apoptosis in a bone morphogenetic
protein 4 (BMP4)-dependent manner. Third, a small percentage of euploid cells rescues embryonic tissue in mosaic gastruloids when mixed with aneuploid cells. Finally, single-cell
RNA-sequencing analysis of early human embryos revealed a
decline of aneuploidy beginning on day 3.
"Our findings challenge two current dogmas: that a single trophectoderm biopsy
at blastocyst stage to perform prenatal genetic testing can
accurately determine the chromosomal make-up of a human
embryo, and that aneuploid embryos should be withheld from
embryo transfer in association with in vitro fertilization."
Although chromosomal mosaicism is common in human
embryos derived from in vitro fertilization (IVF),most IVF centres
consider the mosaic or aneuploid embryos to be abnormal, and thus
withhold them from transfer into uteri.
Indeed, more than 80% of
these embryos contain aneuploid blastomeres, while only 12.5% of
fertilized oocytes are aneuploid7
; approximately 60% of embryos
are euploid-aneuploid mosaic and only 22% are euploid8
. The use
of preimplantation genetic testing for aneuploidy (PGT-A) before
embryo transfer to screen out aneuploidy has been proposed to
improve delivery rates and reduce miscarriages in association with
IVF.
and has become an increasingly common clinical practice.
Whether PGT-A improves IVF outcomes has, however, remained
controversial. The high false-positive and false-negative rates
in PGT-A means that a substantial number of diagnosed aneuploid
or euploid embryos are actually mosaic. As spontaneous and IVF
pregnancies demonstrate similar levels of mosaicism (12% versus
6.3%), excluding all embryos containing aneuploid cells from
transfer would therefore deprive patients of options.
To test whether mosaic human embryos develop normally,
we report on 32 women who underwent frozen-thawed embryo
transfers with 77 blastocysts that were diagnosed as mosaic and
aneuploid by PGT-A. Nine clinical pregnancies were established
(28.2%) from these transfers, 4 of which miscarried (44.4% of
pregnancies, 12.5% of cycles), and the remaining ones were delivered (15.6%; Supplementary Table 1). Characteristics of participants
and IVF cycles are presented in Supplementary Table 2. Median age
was 40.6±4.1 years. Our observed pregnancy and live birth rate
matched or even exceed the national average of expected outcomes
for age-matched individuals who did not use PGT-A diagnostics
(18% pregnancy and 12% live birth rate at age 40). Interestingly,
while all transferred embryos were aneuploid, prenatal chromosomal analyses performed with chronic villus biopsies (CVS) or
amniocenteses in delivered pregnancies uniformly revealed normal
karyotypes. Comprehensive chromosomal analysis on the products
of conception from three participants who miscarried in the first
trimester showed that two demonstrated the same chromosomal
abnormalities as previously detected in the original PGT-A analysis of the transferred embryos (Supplementary Table 1, patients 8
and 9), while the third (patient 7) had a normal karyotype, indicating the elimination of aneuploidy and suggesting a different
cause for her miscarriage. Furthermore, successful cases of transferring diagnosed mosaic embryos have been reported. Together,
these clinical results unveil the developmental capacity of mosaic
embryos, thereby supporting the possibility of a developmental rescue mechanism.
Indeed, an innate ability of the embryo to select against aneu ploid cells has been demonstrated using a mouse model.
• MORE BAD NEWS FOR PGT-...

[@supriyasharma8419]

Sir thank you for explaining such a difficult topic in an easier manner.

[@mohinisoaks]

This is a very good video with good information. The information shared in the video echoes what Dr Gleicher from CHR New York talks about. Thank you Dr Banerjee for explaining it so well.

[@khanshaheen6336]

Thanku sir itne achhe se explain krne k liy

[@ipsitasahu1737]

Thank you sir for such a useful video on this topic. Now such couples can decide whether to go for pgt A or not.

[@nissarivf]

Bottom line PGD PGT is complex I totally agree with you sir nobody has large experience and they give lot of abnormal conflicting reports I took my training in year 2002 for PGD for only 5 markers in Denmark those days embryos has capacity to correct them self it’s nature selection still they can get normal babies even after conflicting PGT.,, excellent video sir ji…,

[@dharmendravankar9706]

Thanks a lot sir

[@suchitraapsingikar5041]

सर पि जि टी ए टेस्ट मे 2 ऐब्रिओ के रिजल्ट एकमेव 4 और दुसरेमे 3 क्रोमोसोम कि कमी आइ है तो ऐविफ नहीं किया जाएगा क्या?

[@MdImran-hz3un]

Agar Kisi ka AMH level 9.75 ho aur uska means bhi regular nehi hai. Aur uske dimbano bhi nehi foot te hai to kya bacha lene may bare problem hai, may Bangladesh se hoo plz zara rply dea jea ..

[@rajuray5368]

Sasthi Mandal 6.21 AMH Sar Mera wife 20 years old PCOD Ki samasya Hai left fallopian tube blocked ovary cyst Aur Mera sperm count zero kya Hamen IVF Karana chahie ya iui IVF ka success rate kitna hai

[@poojatiwari4191]

ek Embryo ka genetic test cost kitna hai aap ke hospital mein

[@sursadhnayoutube1570]

Sir humari 2 betiyan hain Hume koi fertility problem nahi hai Hume ek baby boy chaiye to kya aap help kar paenge

[@vanshikavashisht5086]

Jinke already 1 alive baby he. Kya unko b apne embryos ki pgt karwani chahiye before implantation?

[@Mrslovelylaxmi]

Sir PGTA test me EUPLIod ka matlab kya h..

[@dhruvi1234]

Hi sir me apko mera pgt na report send karu to Kya aap beta sakte ho k wo transfer k layak h ya nai plz

[@reetamadan2775]

Namaste sir, Mere Aur meri pati ki blood group B+ hai aur hamari shaadi relative me se nahi hai. To praganancy ke koi problem to nahi.

[@ganpthshingh4214]

Aap ko help chahiye baby ke liye

[@latikadaskaranjia1356]

Sir husband wife siklesel treat he pgt karwana jaruri he Kiya please bataye

[@swapnilkarke7992]

Sir Vericocele pe video banaiye, Vericocele ke bare me logo ko jankari nahi hai

[@rajeshtiwari6422]

Turnar syndrome ka ilaj kya hai

[@Ajitsinh9327676921]

Sir meri wife ka AMH 0.03 hai age is 25 aur period bhi regular nahi hai. 21 days ki Davai se aate hai to kya ivf se biological mother ban sakti hai. (Please sir please ask these question. It is very important for me) pehle answer me doctor ne bataya ki agar period aate hai to, mere wife k case mein period nahi aate hai. It is unique question.

[@AnupKumar-kk9wp]

Apko baby ho gaya

[@Mrslovelylaxmi]

Bhai aap sir se plg. Ye question puche plg.. Mera 14 saal baad baby hua.. Uska Noser Bone aaya na Bache ka wait bada. Blood flow nhi hua. Our delivery ke 3 day baad bache ki death ho gai.. To me dusra ivf kese karu. Ya embryo ki pgt test karu.. Plg 😭😭

[@komalkamal1382]

Hlo apne PGT-A krwaya hai mera bhi 1 ivf fail ho gya mujhe bhi ye test bola hai, egg quality (4AB, 5AB)

[@rachnagupta6828]

Hello sir, Our 5 th day blastocyst stage embryo is of grade 1. PGT-A result shows aneuploid chaotic. Pls suggest we should either go for transfer or discard. Kindly reply

[@komalkamal1382]

Hlo apne pgt ke bad fir ye transfer krwaya to kya result rha apka Mujhe bhi pgt suggest Kiya hai

[@rahulthakkar5117]

Aapka kya reslut aaya

[@rahulthakkar5117]

Aapka kya result aaya

[@RkSharma-dv3um]

Sir आपके पास ivf कराने ke बाद cesarian delivery कराने ki सुविधा है क्या ? मेरी wife की 3 cesarian हो चुकी है to 4th cesarean delivery after ivf कराना चाहता हूं Sir please answer 🙏

[@yuktasingh986]

Sir daya Karo apni wife par. Wo bhi instan h.

[@ashishmaneshwar9860]

46,XY,22ps+ sir eska elaj kya mail me defect hau ye cromojomal

[@avnikapatel2901]

Right information/we hv to trust nature

[@quazirumana]

How can I contact this doctor

[@aeyshamehira6566]

Hi sir mere FSH hormone levels High hai 11,43, hai period regular hai 28 day k meree egg bhut chote bante hai amh mere 4,8 hai

[@nissarivf]

You have excellent AMH Ayesha….

[@aeyshamehira6566]

@@nissarivf AMH 1,5 hai ...

[@nissarivf]

@@aeyshamehira6566 still not bad we do cases for 0.4 AMH still we get good eggs not many but pregnancy can be achieved….

[@priyankatrivedi7050]

Sar Mere friend ki bete ko hemophiliate hai To Kya IVF Karva kar next per bhi normal ho sakta hai please reply🙏🙏🙏🙏🙏🙏🙏🙏🙏🙏

[@Rajeshpate]

Aap ka problem sholve hua ?

[@geetanjalipandey3860]

Sir aap meri akhiri Ummid hai Meri age 43 hai. Amh 0.43 hai. FSH 21 hai period regular hai kya mai self egg se pregnant ho sakti hu?

[@ganpthshingh4214]

Aap ko help chahiye baby ke liye

[@indiaindia9821]

apki pregnancy hui kya....Mera b same case hai

[@tulikaroy2687]

Sir ERA test par ek video banaye pls. Post receptive ERA result kya hota hai?? Thanks

[@user-jy5ld4yb9h]

What is cost embreyo DNA test

[@sadhanachauhan9587]

P g t kya blatosise me hota hai

[@sunilmastan]

Meri wife ko Dr NE PGT test karwaya .pahle Bola egg teek hai. After five days baad bole ki aapko PGT test karwana padega .kyunki age 40 years hai .baad me PGT test karwake bole ye embryo transfer Nahi honge .humne ab egg donor se liye fir BHI Bolte egg ki quality ok hai but superior quality Nahi . Ab hum un embryo transfer karwaye ki Nahi?

[@komalkamal1382]

Hlo apne PGT-A krwaya hai mera bhi 1 ivf fail ho gya mujhe bhi ye test bola hai, egg quality (4AB, 5AB)

[@suvi6997]

@@komalkamal1382 aapne karwaya kya mam Mera v 4 aa quality par failed ho gya

[@komalkamal1382]

@@suvi6997 nahi krwaya 1 year tak freezing hai abhi rs ki problem hai thodi

[@suvi6997]

@@komalkamal1382 oh .

[@komalkamal1382]

@@suvi6997 hlo apne pgt test krwa liya ya nahi

[@kaushikpatel2250]

Me apka contact kaise karu

[@riyagupta6142]

Sir endometrium 4.4 hi kya normal hi

[@anujchauhan9699]

No .normal 8mm hai periods ke 10th day par

[@riyagupta6142]

@@anujchauhan9699 but mera 1 years se piriod nhi hua tha tabhi ultrasound karaya tha 4.4mm thi

[@riyagupta6142]

@@anujchauhan9699 aur jb tk ilaj hua tabhi tk piriod hua hi 15 manth se menses nhi hua hi.

[@anujchauhan9699]

@@riyagupta6142 aapki age kitni hai.period kyu nahi aaya

[@riyagupta6142]

@@anujchauhan9699 25