Preimplantation genetic diagnosis (PGD) in Turkey: procedure and prices

PGT-A, PGT-M or PGT-SR: which embryo test do you need?

The right test depends on why you are considering PGD. A fertility specialist and a genetic counselor choose it after reviewing your history and, when relevant, your family's genetic results.

PGT-M usually requires preparatory work in a genetics laboratory to identify the exact mutation in the family, which can take time before the IVF cycle starts. None of these tests can detect every genetic condition, and a normal result does not exclude all abnormalities.

Is PGD legal in Turkey, and what are the rules?

IVF and embryo testing are regulated in Turkey by the national regulation on assisted reproduction and the centers that perform it. In general, as we understand it:

• IVF is restricted to married couples using their own eggs and sperm; egg, sperm and embryo donation is prohibited.
• Embryo testing is accepted for medical reasons, such as a known genetic disease or chromosomal problem.
• Choosing the sex of an embryo for non-medical reasons is prohibited. Sex selection is only accepted to avoid a sex-linked genetic disease.

Rules and their interpretation can change, and countries differ on what is allowed, including what you may do with embryos afterward. Ask the partner clinic to confirm in writing what applies to your case, and check the law in your own country before starting.

What is preimplantation genetic diagnosis (PGD) and how is it used in Istanbul?

Preimplantation genetic diagnosis (PGD),also called preimplantation genetic testing (PGT),is a test performed during in vitro fertilization (IVF). A few cells are taken from embryos created in the laboratory and analyzed for genetic or chromosomal abnormalities before an embryo is transferred to the uterus. It aims to reduce the risk of passing on a known hereditary disease and to help select embryos with a better chance of implantation, but it does not guarantee a pregnancy or a healthy baby.

What are PGT-A, PGT-M and PGT-SR?

• PGT-A (aneuploidy screening): looks for an abnormal number of chromosomes.
• PGT-M (monogenic): looks for a specific inherited disease, such as cystic fibrosis, when the mutation in the family is known.
• PGT-SR (structural rearrangements): looks for unbalanced chromosome rearrangements when a parent carries one.

How does it work?

PGD involves taking a small biopsy from each embryo at an early stage of development. These cells are analyzed, and only embryos without the abnormality being tested for are considered for transfer.

PGD vs. prenatal diagnosis: what's the difference?

PGD tests embryos before pregnancy. Prenatal diagnosis tests the fetus during pregnancy. PGD cannot replace prenatal diagnosis, because it does not detect every abnormality.

Interested in PGD in Turkey? Turquie Santé can connect you with partner IVF centers in Istanbul. Request a free initial teleconsultation to discuss your situation.

When PGD is recommended?

Pre-implantation genetic diagnosis (PGD) isn't necessary for every couple undergoing IVF. However, in certain fertility journeys, it can be a crucial step toward achieving a healthy pregnancy, especially when there's an increased risk of genetic or chromosomal complications.

PGD is particularly recommended in the following cases:

• Family history of genetic disorders, such as cystic fibrosis, muscular dystrophy, or hemophilia.
• Fertility issues linked to chromosomal abnormalities in either partner.
• Recurrent miscarriages, often caused by undetected chromosomal issues in the embryos.
• Advanced maternal age (typically over 38),which increases the likelihood of chromosomal anomalies.
• Couples who have already had a child with a genetic condition and want to reduce the risk in a future pregnancy.

If any of these situations apply to you, PGD may be a valuable option.

Talk to a specialist. Our network of fertility and genetics experts is here to guide you. Reach out to Turquie Santé today to find out whether PGD in Turkey could be the right step for your parenthood journey.

How does preimplantation genetic diagnosis (PGD) work in Istanbul, Turkey?

PGD takes place as part of an IVF cycle. In Istanbul, a typical course follows these steps:

1. Ovarian stimulation: hormone injections stimulate the ovaries to produce several eggs.
2. Egg retrieval: the eggs are collected under light sedation in a short procedure.
3. Fertilization (IVF or ICSI): the eggs are fertilized in the laboratory with the partner's sperm.
4. Embryo culture: embryos develop in the laboratory for 3 to 5 days.
5. Embryo biopsy: a few cells are removed from each embryo. When performed by an experienced team the biopsy is considered safe, but a small risk to the embryo cannot be excluded.
6. Genetic analysis: the cells are analyzed to detect the abnormality being tested for. Embryos are often frozen while waiting for the result.
7. Transfer: an embryo without a detectable abnormality is selected and transferred to the uterus, often in a later cycle.

Turquie Santé coordinates your file, appointments and travel. The medical decisions remain with your fertility specialist and genetic counselor.

Benefits of preimplantation genetic testing (PGT)

Preimplantation genetic testing (PGT) can help couples facing a known genetic risk or repeated unsuccessful IVF cycles. The main potential benefits are:

• Lower risk of passing on a known inherited disease (PGT-M),when the mutation in the family is identified.
• Selection of chromosomally normal embryos (PGT-A),which can improve the chance of implantation per transfer in some groups of patients; it does not increase the chance of a baby for every patient.
• Fewer transfers of embryos that are unlikely to implant, which may shorten the time to a pregnancy in some cases.
• Embryo freezing: healthy embryos not transferred during the first cycle can be frozen for future attempts.

The benefit of PGT depends on your age, your indication and the number of embryos available. Discuss it with your fertility specialist before deciding.

Limitations and considerations of PGD

PGD has benefits, but also limits and risks. Being informed helps you set realistic expectations.

The rules on embryo selection differ between countries. Check the legal framework in Turkey and in your own country before starting. Send your medical file to Turquie Santé to obtain a personalized plan from partner clinics.

What is the success rate of PGD in Turkey?

There is no single success rate for PGD. Success depends mainly on the woman's age when the eggs are retrieved, the number and quality of embryos, the reason for PGD and the clinic.

• Age is the main factor: the chance of a live birth per embryo transfer is higher with eggs from younger women.
• Results should be given per embryo transfer and per started cycle, because these figures differ. A rate quoted per transfer will look higher than a rate per started cycle.
• Some cycles end without any embryo suitable for transfer.

Before choosing a clinic, ask it for its own results by age group, how they are calculated, and the number of cycles behind them. Published rates from clinics are not independently verified, and no result is guaranteed. Contact Turquie Santé for an evaluation of your file and a comparison of partner clinics.

How to choose a PGD clinic in Turkey: questions to ask

Before booking, ask the clinic for written answers to these questions:

• Which genetic laboratory analyzes the biopsies, and is it accredited? Who performs the embryo biopsy and how many have they done?
• Which test do you recommend for my situation (PGT-A, PGT-M or PGT-SR),and why?
• What are your results for patients of my age, per embryo transfer and per started cycle?
• What does the quote include: stimulation medication, egg retrieval, ICSI, biopsy, genetic analysis, embryo freezing and transfer?
• What happens if there are no embryos to test or no embryo is suitable for transfer?
• How long will I need to stay in Turkey, and will I need to come back for a frozen embryo transfer?
• Who follows me after I return home, and how are results shared with my own doctor?

Turquie Santé is a coordination service, not a medical provider: it can help you collect this information from partner clinics, but treatment decisions are made by the clinic's doctors.