Fortis Hospital: Your Guide to Preimplantation Genetic Screening for a Healthy Family

Preimplantation genetic screening  in India

Preimplantation Genetic Screening (PGS/PGT-A) is a laboratory method performed when undergoing in vitro fertilization (IVF) to screen embryos with chromosomal abnormalities (extra or missing chromosomes) prior to implantation into the uterus.

Purpose

• To pick embryos whose number of chromosomes is normal (euploid embryos).
• To prevent risk of miscarriage or implantation failure.
• In order to enhance the chances of success in IVF, particularly in women of advanced maternal age or those who have gone through a series of IVF failures.

Who May Benefit

• Women who are older than 35 years (increased risk of chromosomal errors).
• Couples that have repeated IVF failure.
• Those couples who have frequent miscarriages.
• Male infertility due to poor sperm quality (poor sperm quality may amplify chromosome problems).
• Couples, who want to minimize the potential of developing chromosome-related diseases such as Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), etc.

The Process:

IVF & Embryo Development

• Eggs are collected, fertilized by sperm and given a chance to develop in the lab until the blastocyst stage (Day 56).

Embryo Biopsy

• Some of the cells are carefully scraped off the trophectoderm (outermost layer which gives rise to the placenta, not embryo itself).

Genetic Testing

Advanced techniques are used to test the cells and they include:

• NGS (Next-Generation Sequencing) - the most accurate and common.
• Array Comparative Genomic Hybridization aCGH - previous technique.
• qPCR – sometimes used.

Embryo Selection

• Transfer is only done to chromosomally normal embryos (euploid).
• They do not use abnormal embryos (aneuploid).

Embryo Transfer

• The chosen healthy embryo is inserted in fresh or frozen cycle into the uterus.

Benefits

• Improves probability of healthy pregnancy.
• Reduces miscarriage rates.
• Helps prevent embryo transfer of severe chromosomal defects.
• May shorten the time and number of IVF cycles to get pregnant.

Best PGS treatment hospitals in India

Fortis Hospital

Fortis Bloom IVF centre at FMRI, Gurugram

The clinic is an infertility center located within the Fortis Memorial Research Institute (FMRI) and it provides numerous fertility treatments such as IVF, ICSI, embryo freezing, surrogacy and, most famously, Preimplantation Genetic Testing (PGT)- which includes screening chromosomal abnormalities (PGT-A) among others. FMRI is a NABH-recognized quaternary care center with an excellent reputation in terms of technological excellence and multidisciplinary care in high-risk and complex IVF cases.

Extensive Genetic Services attached to Fortis

In addition to the IVF arm, Fortis Healthcare has a strong Department of Medical Genetics that has:

• Even more advanced genetic testing (including chromosomal and single-gene disorders),
• Expert genetic counselling,
• Pre-natal and reproductive genetic services. 
• They also have state-of-the-art genomics capabilities at the Fortis Institute of Genomic Medicine in Gurugram, including whole genome/exome sequencing, prenatal screening, and customized reproductive advice.

Advanced PGS treatment for IVF in India

Advanced PGS involves next-generation genetic testing technologies to detect chromosomally normal embryos during an IVF cycle to enhance the success of implantation and a healthy pregnancy.

In contrast to traditional procedures (like FISH), the best PGS can provide detailed and very precise results.

Advanced Techniques Used

Next-Generation Sequencing (NGS)

• The most popular and precise.
• Will be able to identify any minor chromosomal abnormalities.
• Gives specific analysis of embryo chromosomes.

Comparative Genomic Hybridization (cGH)

• Scans every chromosome, but at a lower level than NGS.
• Another type that was previously common but has been mostly replaced by NGS.

qPCR (Quantitative PCR)

• Fast, but limited in scope.
• Not used a lot in advanced testing.

Karyomapping / SNP Array

• Helpful in conjunction with family history and advanced cases.
• Aids in the identification of inherited rearrangements of chromosomes.

Process in Advanced PGS

• IVF & Embryo Culture → Embryos are cultured to the blastocyst level (Day 56).
• Embryo Biopsy → A small number of cells are taken away the trophectoderm (outer layer, which forms placenta).
• Genetic Testing (NGS, aCGH, SNP array, etc.) → Chromosomes are studied.
• Embryo Selection -Only euploid (chromosomally normal) embryos are transferred.
• Transfer or Freezing - Healthy embryo(s) are transferred into the uterus, or frozen to be used later.

Benefits of Advanced PGS

• Indeed, greater precision on the identification of aneuploid embryos.
• Increased success rates of IVF in each transfer.
• Decreased risk of miscarriage (miscarriage of the embryo with chromosomal abnormalities happens quite frequently).
• Better pregnancy results with minimal development of chromosomal disorders such as Down syndrome.
• Reduced time to pregnancy (reduced failed transfers).

Who is to think of Advanced PGS?

• Advanced maternal age (35+) women.
• Couples having multiple IVF failures.
• Couples, which have frequent miscarriages.
• Extreme cases of infertility in men.
• Couples who are at risk of transmitting abnormalities into child.

Factors Affecting Cost of preimplantation genetic screening in India

The most important aspects that can affect the price of Preimplantation Genetic Screening (PGS/PGT-A) in the framework of IVF in India with the existing data:

Key Cost-Motivated Factors:

Clinic Geographic Location

• The overheads and demand are high in major metropolitan cities such as Delhi, Mumbai, and Bangalore, and this explains why these kinds of treatment centers are chargeable at a higher cost.
• On the other hand, non-metro clinics like Jaipur and Coimbatore could offer the same at a cheaper price.

Clinic Reputation, Infrastructure & Success Rates

• Premium fees tend to be charged on established clinics with modern labs and better metrics of success.

Complexity & Scope of Services

Prices differ widely by genetic testing category:

• Simple per-embryo PGS through a lab such as DNA Labs.
• Multidisciplinary packages (including biopsy, counselling, freezing, etc.) may be more expensive.

Extra Services & Add-Ons

• Services such as embryo freezing, storage time-lapse imaging, donor egg/sperm use, higher IVF protocols (e.g. ICSI) and other laboratory augmentations are likely to increase costs.

Individualization to Treatment and Profile of patient

• Patients with multiple cycles of IVF, complicated stimulation regimens, or with difficult fertility prognoses can be more expensive.

Medications, Diagnostics and Lab work

• Ovarian stimulation medications and diagnostic tests (blood tests, ultrasounds, semen analysis) are not priced equally in all clinics. These are the major additions to the overall bill.

Preimplantation genetic screening in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

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• Expert doctor with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
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