PGD/PGS in singapore during IVF

honeybaby1

New Member
Hello all,

My DH's semen analysis reported oligoasthenoteratozoospermia with very low sperm count. Chromosome analysis was done and was diagnosed with Y chromosome deletion (complete deletion of AZFc) which is the reason for bad sperm quality. IVF with ICSI is the only option but if we end with a boy, Y chromosome deletion will be inherited which means all sons will have same problem and we dont want to pass on this problem to our next generation. PGS/PGD test can be done to diagnose any genetic diseases in the embryo or check for chromsome imbalance (these tests will also have have gender information of the embryo). I understand PGS/PGD is allowed in Singapore only if there are genetic issues. I have 2 questions..

1. Is Y Chromosome deletion considered as genetic issue and will Singapore Health Board (Medical ethics board) allow PGD/PGS done during IVF?
2. Since this genetic issue is gender specific, will they allow disclosing of gender of the embryo and allow implanting only girl embryo?

Thanks in advance!
 


pancakess

New Member
Hi, I think the best way to find out will be to consult with the IVF doctor and find out if there was a precedent for doing PGD on your condition, however to my knowledge this procedure is only allowed for potentially life-threatening conditions. There is really a lack of information on the public domain on PGD cases in SG so it would be better to check directly with the doctor, or potentially a genetic counselor.
 

Azukin

New Member
Hi honey baby1, I just went through a cycle of IVF PGD myself.
My husband has a pair of chromosomes that has translocation (found during genetic testing) hence we needed the PGD.
To answer your 1st question, yes, your husband’s genetic issue is considered and will be eligible under PGD testing.
For your 2nd question: no, in SG, it is not ethical to disclose gender to couples for IVF no matter the situation. However, what pgd does is that it will give a report on your blastocysts on whether it is chromosomally balanced or not.
And since you say the issue is a Y chromosome deletion, this means that if your blastocyst result is ‘not balanced’, you can assume that it might have been a male, and if the blastocyst result is ‘balanced’, it is almost highly likely that it is a female/ you can regard it as a female. if any of your blastocysts inherits this ‘y deletion chromosome’, it will most probably be diagnosed under PGD as ‘not chromosomally balanced’.
However, you will still need to check with your gynae whether there is a PGD testing kit available for your DH’s condition. Currently there is only one PGD center in SG which is in NUH. but IVF clinics will be able to help check with the PGD center if they have the test kit for this specific condition.
I hope this helps.
 

RedNose

New Member
Hi honey baby1, I just went through a cycle of IVF PGD myself.
My husband has a pair of chromosomes that has translocation (found during genetic testing) hence we needed the PGD.
To answer your 1st question, yes, your husband’s genetic issue is considered and will be eligible under PGD testing.
For your 2nd question: no, in SG, it is not ethical to disclose gender to couples for IVF no matter the situation. However, what pgd does is that it will give a report on your blastocysts on whether it is chromosomally balanced or not.
And since you say the issue is a Y chromosome deletion, this means that if your blastocyst result is ‘not balanced’, you can assume that it might have been a male, and if the blastocyst result is ‘balanced’, it is almost highly likely that it is a female/ you can regard it as a female. if any of your blastocysts inherits this ‘y deletion chromosome’, it will most probably be diagnosed under PGD as ‘not chromosomally balanced’.
However, you will still need to check with your gynae whether there is a PGD testing kit available for your DH’s condition. Currently there is only one PGD center in SG which is in NUH. but IVF clinics will be able to help check with the PGD center if they have the test kit for this specific condition.
I hope this helps.

Honey baby1,

I'm doing PGS IVF next month at NUH. Have had 2 Fresh and1 FET cycles. Last one ended in MC.
Any updates on your IVF PGD cycle? I don't know anyone doing PGD or PGS, I'm interested to hear about your experience and results. Hope you can share!

All the best to you!
 

RedNose

New Member
Hi honey baby1, I just went through a cycle of IVF PGD myself.
My husband has a pair of chromosomes that has translocation (found during genetic testing) hence we needed the PGD.
To answer your 1st question, yes, your husband’s genetic issue is considered and will be eligible under PGD testing.
For your 2nd question: no, in SG, it is not ethical to disclose gender to couples for IVF no matter the situation. However, what pgd does is that it will give a report on your blastocysts on whether it is chromosomally balanced or not.
And since you say the issue is a Y chromosome deletion, this means that if your blastocyst result is ‘not balanced’, you can assume that it might have been a male, and if the blastocyst result is ‘balanced’, it is almost highly likely that it is a female/ you can regard it as a female. if any of your blastocysts inherits this ‘y deletion chromosome’, it will most probably be diagnosed under PGD as ‘not chromosomally balanced’.
However, you will still need to check with your gynae whether there is a PGD testing kit available for your DH’s condition. Currently there is only one PGD center in SG which is in NUH. but IVF clinics will be able to help check with the PGD center if they have the test kit for this specific condition.
I hope this helps.


Hi Azukin,

Thanks for spotting that I tagged the wrong name! Yes, I’d like to know more about your case and your experience with PGD. I’ve also sent you a private message :)

Baby dust to all of us here!

RedNose
 

bianbianni

New Member
Hi Astiva

We just had our genetic counselling session and the doctor told us that pgd cannot distinguish between normal genes vs genes with balanced translocation (carrier)? Is that true? Coz another doctor seemed to say that it can be distinguished during PGD...
 

astiva

Member
Hi Astiva

We just had our genetic counselling session and the doctor told us that pgd cannot distinguish between normal genes vs genes with balanced translocation (carrier)? Is that true? Coz another doctor seemed to say that it can be distinguished during PGD...
For balanced translocation (my condition), the tech can only differentiate between balanced (normal OR carrier will list as balanced) and abnormal. For other genetic abnormalities, it may be different, I don’t know.
 

bianbianni

New Member
I see. Thanks for the clarification. We have balanced translocation too. I seemed to read online that there are new ways to distinguish, maybe it’s not offered in SG?
 

astiva

Member
I see. Thanks for the clarification. We have balanced translocation too. I seemed to read online that there are new ways to distinguish, maybe it’s not offered in SG?
There is only one lab in the US that can distinguish between a balanced or a normal embryo: Pacgenomics. I haven’t heard of any other lab who can do this. But why this concern? Carriers are perfectly healthy.
 

astiva

Member
Hi Astiva,
I am Nathaniel from CNA. We are still looking to interview a mom/couple/kid who has experienced PGD for a documentary series called "Why It Matters". We were hoping you could help us in our search; is there anyone you know who might be willing to participate in an interview? We really just want to show the efficacy of PGD in Singapore, and the benefits or issues that might come with it. We want to feature the stories of Singaporean moms.

Thank you! You may contact me at [email protected] or [email protected]
I emailed you already
 
Hi, anyone here doing PGS (also known as PGT-A) due to (i) Advanced Maternal Age, (ii) Recurrent Miscarriages, (iii) Low ovarian reserves, and (iv) Repeated IVF failures? Please kindly share your story. I am a bit skeptical of PGD helping to improve IVF success rates because it does nothing to improve egg or embryo quality. I think that it is purely diagnostic and not at all therapeutic.

A parable to illustrate this point is as follows:

A farmer has a hen that has laid 10 eggs. Out of these 10 eggs, only 3 are fertilized and will hatch chicks. The remaining 7 are unfertilized and will eventually go rotten. So the farmer uses a lighted candle in a dark room to look for the presence of a developing chick embryo within each egg, and identifies the 3 fertilized eggs. The lighted candle in this story is equivalent to PGS / PGT-A. Can using the lighted candle increase the number of fertilized eggs and hatched chicks? The obvious answer is no.

So without PGD, patients may have to do more transfers, but eventually, their good embryo will be transferred one day. So the final cumulative chances of success remain the same? Please give your opinion.

Here are some interesting videos that discuss these issues:






 
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False positives during PGS / PGT-A may arise because of mosaic embryos that contain a mixture of genetically abnormal and normal cells. There have been many reports that these mosaic embryos can give rise to normal healthy births. So the cumulative chance of success may not increase by PGS / PGT-A and may even decrease by excluding "mosaic" embryos, that could have developed into a healthy normal baby. As seen in the attached diagram of a blastocyst stage embryo, the ICM gives rise to the embryo, while the TE gives rise to the placenta and yolk sac. Testing a few cells from the TE only gives you a probability about what's going on in the ICM. An embryo with abnormal (aneuploid) TE but normal ICM most likely will still make a healthy baby.
 

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Yan01

New Member
Hi,
My doc just told us that we need to attend a genetic counselling given our case.
Our doctor suggest that we definitely need IVF+ PGD.
Can I check for PGD, how does it work?
 

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