During consultations to discuss PGD a large amount of information is discussed with the couple and so it is advisable to give the patients information leaflets on IVF and PGD and a written summary of the consultation. Communication with the patient's GP and clinical geneticist is essential. After the consultation the patients should be given time to discuss the option of PGD, but if they decide to embark on treatment, all the necessary preliminary tests required for IVF should be undertaken (see above and Chapter 5).
It is important to explain to the patients exactly what will occur during the PGD cycle; which diseases are being tested for, the limitations of the procedure, the possibility that all of the embryos may be affected, and the pregnancy rates must be discussed with the patients before treatment. For PGD to be successful, a good number of embryos are required so that at least two unaffected embryos of good morphology are available for transfer. Therefore, patients require quite aggressive stimulation.
For PGD, ICSI is used when a PCR diagnosis is performed to avoid contamination by sperm that may become embedded in the zona during in vitro fertilization.
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