A guide to the PGD process
Stages 1 & 2: Down-regulation
Stimulation of the natural female hormonal cycle
Stage 3: Egg Collection
Stage 4: Fertilisation
Stage 5: Embryo Selection
Stage 6: Embryo Transfer
Stage 7: Post treatment support and pregnancy
We work to an established programme which has been validated over hundreds of treatments.
This programme is fully explained on this website and in our detailed information. In the interests of all patients, no variations to this treatment programme are permissible under any circumstances. Anyone unwilling to comply with this provision will be excluded from the programme.
Please remember that medical responsibility for your care during treatment in the UK rests with The Rainsbury Clinic. Responsibility for your treatment abroad rests with the treatment centre.
If you have any worries about your treatment you should immediately contact the relevant clinic.
Stages 1 & 2: Down-regulation and stimulation of the natural female hormonal cycle .
The availability of multiple eggs is essential so that our embryologists can fertilise a number of eggs with the partner’s sperm prior to gender selection and replace the chosen embryos into the female’s uterus.
1. We down-regulate the woman’s natural hormones, using a daily injection for 14 days. This switches off the release of hormones which normally stimulate the ovaries. The injection is started on Day 21 of the menstrual cycle and is used for approximately 14 days. This is followed by an examination, blood test or scan at the end of the woman’s period using the injection to ensure that full down-regulation has been achieved.
2. The stimulation phase is when daily injections containing the human gonadotrophin hormones (egg maturing hormones) are administered by sub-cutaneous injection for a period of 10 to 14 days to stimulate the ovaries into producing a number of egg follicles. A series of scans help determine the rate of follicular growth in each ovary and further blood tests may be done to confirm follicular development.
3. After 10 or 11 days, a different type of hormone is administered to complete the follicle ripening process and prepare the follicles for egg collection. This last phase of treatment is, in most cases, carried out before the couple travels to an associate clinics abroad for the remaining stages to be completed.
Stage 3: Egg Collection
This straight-forward procedure takes 20-30 minutes and is usually carried out under a local anaesthetic, using transvaginal ultrasound
directed egg recovery to provide high definition images on a scanner monitor to ensure pinpoint accuracy. The procedure involves drawing
the fluid from each follicle using a vaginal probe and needle. The content of each follicle is passed directly to the embryologist working in an adjacent laboratory. As each egg is found, the gynaecologist will move on to the next ripe follicle – usually 8 follicles from each ovary will be aspirated producing around 10-12 mature eggs. *See p.9 of brochure – “collect 8 eggs”
Stage 4: Fertilisation
After the ‘egg harvest’, a semen sample from the male will be carefully prepared prior to its use in Intra-Cytoplasmic Sperm Injection (ICSI)
or standard IVF insemination procedures, to give the highest fertilisation rate possible. The fertilised eggs, which are now known as embryos,
are usually allowed to develop to the eight-cell stage (blastocyst).
Stage 5: Embryo Selection
Usually by day 3-4 (after fertilisation), the new embryos will have reached a sufficient stage of development to enable the Clinic’s embryology team to differentiate the gender of individual embryos using PGD and the normality of the embryo’s chromosomes. We aim to replace 2 or 3 embryos of the couple’s chosen gender in the female’s womb, depending on the woman’s age and the couple’s chance with regard to embryo return.
The moment that most couples look forward to is when their embryos are transferred from the laboratory to the uterus, using a very fine catheter. The procedure is quick and painless. The cervix (neck of the womb) is visualised by passing a speculum into the vagina, before the tip of the catheter is passed through the cervical canal into the uterus. To ensure that the tip of the catheter is in the best possible location within the uterus, an abdominal scan is often used. Finally, when the gynaecologist has located the optimum position, the embryos are gently transferred from the syringe, settling in the lining of the womb.
After a rest following embryo transfer, our female patient is ready to join her partner, hopefully looking forward to a successful and happy pregnancy.
One of the most often repeated questions is: “What can I do to maximise my chance of the embryos implanting?” The answer, realistically, is very little – other than to avoid any heavy lifting, strenuous activity or over-zealous housework for about a week after embryo transfer. The female partner should also, of course, avoid becoming over tired or stressed – but in all normal circumstances, she can resume a full, active life, going back to work, if appropriate.
After egg collection, we start the female on a course of progesterone – a hormone which nurtures the lining of the womb (endometrium) and encourages embryo implantation. This usually continues for 6-8 weeks after embryo transfer, but it is not uncommon for the hormone to be maintained until much further into the pregnancy – when, around the 12th week, the placenta takes over the hormonal support function.
The drugs for the first eight weeks after embryo transfer are supplied as part of the treatment programme, but further supplies for up to an additional four weeks will be charged, if required.
In most pregnancies arising from PGD, there will be no need for anything more than the routine antenatal monitoring which should be provided through your usual doctor or health service. However, our interest doesn’t stop when you complete the programme after embryo transfer. We ask all couples to keep in close contact with us and alert us to any concerns or difficulties immediately. Pregnancy can produce a variety of side-effects and no two pregnancies are the same. We will respond to any concerns quickly and effectively with the advice you need.
If at any time, you become worried about any aspect of the pregnancy, we can arrange for a second opinion. This will be provided as close to your home as possible and will include any necessary tests and examinations. This is not part of the treatment and costs will be incurred, so you should always consult your own doctor first. Private antenatal care and delivery can be arranged if required (and the provider will be able to give you detailed cost information).
Because this programme utilises assisted conception and embryology techniques widely used throughout the world for many years, the associated risks and complications are few, and small. However, as with any surgical procedure, there are slight risks of infection, together with a small risk of ectopic or multiple pregnancies, miscarriage, and of ovarian hyperstimulation, when the ovaries over-respond to the drug regime, requiring the treatment to be cancelled. Because patients are carefully monitored throughout their treatment and pregnancy, there is very little risk of these complications. We would simply ask to be informed in the event of any concern, however small.
Rest assured, our sole aim is to help you to achieve healthy, normal baby of your chosen gender.
For more detailed information please click here for a copy of your full guide which you can download and print for future reference.
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