Consent form for Requesting PGT-A Testing of Embryos

PGT-A (Pre-Implantation Genetic Testing for Aneuploidy)

Note: Kindly read the online Patient Information regarding PGT-A prior to signing this form. Without this information, you cannot make an informed decision.

ESSENTIAL INFORMATION:

• PGT-A is an embryo selection tool, identifying embryos with a higher potential and improving IVF outcomes.
• PGT-A is not a guarantee of a healthy pregnancy or a healthy baby.
• PGT-A is not compulsory, and it is entirely optional.
• When transferring tested embryos, the total pregnancies and livebirths will be the same as untested embryos, however this will be achieved through less transfers.
• PGT-A is associated with additional costs over and above IVF.
• You can choose not to test all your available embryos.
• There are options for freezing untested embryos, or for biopsy of embryos, without immediate testing.
• These options can be discussed with your Co-ordinator or treating doctor and can assist in reducing cost.
• PGT-A results become available after 10 working days from the date of embryo biopsy.

ADVANTAGES:

• PGT-A is a means of screening embryos prior to transfer.
• Selection of embryos with a normal chromosome number (Euploid) allows for:
• A higher implantation rate (Pregnancy rate per embryo transferred).
• Lower first trimester miscarriage rate (70% reduction).
• Reduced risk of Genetic Syndromes related to abnormal chromosome number.
• Trisomy: Down's Syndrome, Edward's Syndrome, Patau's Syndrome, or Monosomy: Turner's Syndrome is almost eliminated (99.89% reduction).
• The sex of the embryo is revealed prior to embryo transfer and can be nominated.
• PGT-A avoids the transfer and storage of embryos with no potential, thus avoiding costs.
• PGT-A allows for pregnancy success in fewer embryo transfer cycles.

DISADVANTAGES:

• PGT-A does not guarantee a pregnancy.
• There are factors aside from the genetics of the embryo which influence implantation.
• PGT-A is associated with a per-embryo cost, in addition to the cost of the IVF.
• Untested embryo transfer in women aged younger than 38yrs old, will yield the same eventual pregnancy and livebirth rates as euploid embryo transfers.
• This will be at the cost of additional transfer cycles, longer time to pregnancy, and the possibility of miscarriage and syndrome risk unadjusted for female age.
• PGT-A is not a guarantee of a normal healthy baby, rather an embryo selection tool, improving IVF outcomes (Pregnancy rate per transfer).
• PGT-A does not detect single gene (monogenic) abnormalities, point mutations, subtle inversions, deletions or translocations.
• There are over 7000 conditions associated with single gene disorders, that PGT-A will not detect.
• Developmental abnormalities can still occur in utero, despite a chromosomally normal (euploid) embryo.
• These include structural, neurodevelopmental, behavioural and fetal growth abnormalities, none of which can be predicted by PGT-A.
• PGT-A is not a substitute for prenatal testing during pregnancy.
• The Nuchal Translucency (NT) Screen and Anatomy Scan are still indicated.
• You will know the sex of the embryo beforehand.
• There is additional emotional burden associated with an unsuccessful transfer, and increased turmoil when faced with decisions regarding excess, unwanted embryos.

ESSENTIAL INFORMATION:

• The embryo biopsy, testing, freezing and device costs quoted, are an individual embryo cost.
• This means the cost of testing several embryos is a multiple of the individual quoted costs per embryo.
• The only cost unaffected by the number of embryos, is the annual storage cost.
• It is possible for all the embryos which are tested, to have an abnormal chromosome number (Aneuploid) and be unsuitable for transfer.
• Aneuploid embryos have no potential to give healthy pregnancy and are discarded.

Patient Consent:

Partner Consent:

Additionally:

I / We have had the opportunity to discuss the process of PGT-A embryo testing with my treating doctor and nursing co-ordinator.
I / We understand the limitations of the PGT-A test and the additional costs involved in this process, over and above IVF itself.
I / We also understand the benefits outlined, and on the balance of the presented evidence, feel the advantages outweigh the disadvantages.
I / We would like to proceed with PGT-A testing of embryos prior to transfer.
I / We understand that the final costs related to PGT-A will depend on the number of embryos available for biopsy, and that options are available, in the event of multiple embryos, to allow for freezing with or without biopsy, to limit costs.

REQUIREMENTS FOR INTERPRETER: