Khalil Faaed: The Future of niPGT-A Is Not Just Non-Invasive…
Khalil Faaed, Embryologist at Modern IVF Center, shared a post on LinkedIn about a paper by Divreena Talwar et al. published in Scientific Reports:
”The future of niPGT-A is not just non-invasive. It must be clinically predictive.
Non-invasive PGT-A is one of the most exciting developments in modern embryo testing.
The concept is compelling: instead of removing cells from the blastocyst, we analyze cell-free DNA released into the spent culture medium.
But a critical question remains: Can detecting embryonic DNA tell us what we actually need to know about the embryo?
A recent multicentric study in Scientific Reports provides an important perspective. In this cohort, biopsy-based PGT-A was associated with higher clinical pregnancy, ongoing pregnancy, and live-birth rates than niPGT-A even among embryos classified as euploid.
This finding does not mean that niPGT-A has no future. Instead, it highlights a fundamental challenge: The DNA found in culture medium may not perfectly represent the biological state of the embryo.
Its signal may be influenced by DNA quantity and quality, cellular origin, apoptotic cells, cellular debris, maternal-cell contamination, mosaicism, and technical limitations in low-input DNA analysis.
And this leads to an important distinction:
Analytical concordance is not the same as clinical validity. It is one thing to demonstrate that a test can classify chromosomes. It is another to demonstrate that the result can reliably identify the embryo with the highest probability of implantation and live birth. The next generation of niPGT-A therefore needs to answer a much harder question: Are we measuring the embryo or are we measuring a biological signal released by the embryo?
The future may not belong to a test that is simply non-invasive. It will belong to a test that is non-invasive, biologically representative, reproducible, and clinically predictive.
That is where the real challenge and opportunity for IVF embryology begins.”
Title: Comparative clinical and reproductive outcomes following non-invasive versus biopsy-based preimplantation genetic testing for aneuploidy: a multicentric cohort study
Authors: Divreena Talwar, Naval Shah, Marcos Meseguer, Ritesh Aggarwal, Kshitiz Murdia, Nitiz Murdia, Bhagwat Singh, Sourav Rathore, Vipin Chandra
You can read the Full Article in Scientific Reports.
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