Angelica Cheng
Active Member
A couple of months ago, before all the coronavirus lockdowns, me and my husband visited and inquired about egg donation at three Malaysian IVF clinics. All 3 clinics strongly advocated that we should use PGS / PGT-A with egg donation. They told us that because it is difficult to verify whether the anonymous egg donor has a family history of genetic diseases, we should play safe by using PGS / PGT-A. Apparently, the only information about the donor's family heath history comes from a Questionnaire form that is filled by the donor herself, and the reliability of such information cannot be guaranteed. Additionally, these IVF clinics also attempted to hard-sell PGS / PGT-A by touting the use of the procedure for sex selection, and trying to play on our biased preference for either a boy or girl.
However, I became skeptical when I came across a newspaper article in Today Online entitled: “Overseas egg donors — what Singaporean women should be wary of”. The article suggested that similar genetic tests on the egg donor's blood sample is a much cheaper alternative to PGS / PGT-A for screening the presence of defective genes carried by the prospective egg donor. What I understand is that there is much more DNA genetic material within a blood sample containing thousands of white blood cells, as compared to just a few cells from an embryo biopsy during the PGS/PGT-A procedure, which makes it easier and cheaper to do genetic testing. This made me wonder why none of the 3 clinics that I visited bothered to suggest genetic testing of blood samples. Could this because they wanted to earn extra money from the PGS / PGT-A procedure, rather than doing what is best for the patient? If that is the case, I am extremely angry that the clinics played on our fears of potential genetic defects carried by the anonymous egg donor.
Here is an excerpt from the article:
https://www.todayonline.com/commentary/overseas-egg-donors-what-singaporean-women-should-be-wary
Other claims may have less scientific basis. For example, many foreign fertility clinics strongly encourage their patients undergoing egg donation to utilise preimplantation genetic screening (PGS) to detect genetic defects in the conceived embryos, due to the unknown genetic heritage of the anonymous foreign egg donor. Yet they often neglect to tell patients that similar genetic screening of the donor’s blood sample is much cheaper than PGS.
Patients must also be aware that PGS is not a fool-proof method to detect genetic abnormalities in embryos, despite its high costs.There is a only a limited panel of common genetic diseases that PGS will detect, so it is impossible to screen and verify the entire genome of each individual embryo to be free of genetic defects. One notable example that cannot be detected by PGS is Autism Spectrum Disorders that are caused by multiple genes interacting with multiple factors within the birth environment. Additionally, if the egg donor is very young, it is unnecessary to utilise PGS to screen for Down syndrome that usually arises from genetic abnormalities in the eggs of older women.
Although many fertility clinics claim that PGS can improve the IVF success rates of older women, this only refers to older women using their own eggs, which have a high incidence of genetic abnormalities. PGS will not improve the success rates of older women using a young egg donor.
It must also be noted that PGS is not completely risk-free. There is a small chance of damaging the embryo as this delicate procedure involves drilling a hole through its protective shell (zona), to extract cells for genetic testing.
However, I became skeptical when I came across a newspaper article in Today Online entitled: “Overseas egg donors — what Singaporean women should be wary of”. The article suggested that similar genetic tests on the egg donor's blood sample is a much cheaper alternative to PGS / PGT-A for screening the presence of defective genes carried by the prospective egg donor. What I understand is that there is much more DNA genetic material within a blood sample containing thousands of white blood cells, as compared to just a few cells from an embryo biopsy during the PGS/PGT-A procedure, which makes it easier and cheaper to do genetic testing. This made me wonder why none of the 3 clinics that I visited bothered to suggest genetic testing of blood samples. Could this because they wanted to earn extra money from the PGS / PGT-A procedure, rather than doing what is best for the patient? If that is the case, I am extremely angry that the clinics played on our fears of potential genetic defects carried by the anonymous egg donor.
Here is an excerpt from the article:
https://www.todayonline.com/commentary/overseas-egg-donors-what-singaporean-women-should-be-wary
Other claims may have less scientific basis. For example, many foreign fertility clinics strongly encourage their patients undergoing egg donation to utilise preimplantation genetic screening (PGS) to detect genetic defects in the conceived embryos, due to the unknown genetic heritage of the anonymous foreign egg donor. Yet they often neglect to tell patients that similar genetic screening of the donor’s blood sample is much cheaper than PGS.
Patients must also be aware that PGS is not a fool-proof method to detect genetic abnormalities in embryos, despite its high costs.There is a only a limited panel of common genetic diseases that PGS will detect, so it is impossible to screen and verify the entire genome of each individual embryo to be free of genetic defects. One notable example that cannot be detected by PGS is Autism Spectrum Disorders that are caused by multiple genes interacting with multiple factors within the birth environment. Additionally, if the egg donor is very young, it is unnecessary to utilise PGS to screen for Down syndrome that usually arises from genetic abnormalities in the eggs of older women.
Although many fertility clinics claim that PGS can improve the IVF success rates of older women, this only refers to older women using their own eggs, which have a high incidence of genetic abnormalities. PGS will not improve the success rates of older women using a young egg donor.
It must also be noted that PGS is not completely risk-free. There is a small chance of damaging the embryo as this delicate procedure involves drilling a hole through its protective shell (zona), to extract cells for genetic testing.
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