PGD has been around in various forms for over a quarter of a century now. During this time it has evolved from simple FISH and direct PCR mutation analysis to whole chromosome profiling using microarrays or next generation sequencing and improved monogene testing using STR linkage or now, recombination mapping. Modern PGD can now deliver highly accurate and reproducible results capable of identifying the best embryo to transfer with pregnancy rates unimaginable only a relatively short time ago. So, how has this all come about? And is it all necessary for the best patient outcome? Technology has been a big driver in delivering a more complete and comprehensive suite- but it all comes at a price. Is it all essential? Is there even more that will still be needed? Is there still a place for the older technologies? Are there other considerations that can deliver the same opportunities? What is needed to be able to effectively implement a successful PGD program in a clinic? I will attempt to answer these questions and provide context for how the most appropriate approaches to PGD can be selected and what will be required of the clinic and the laboratory for maximum gains. Different circumstances will require different solutions and this needs to be understood by all involved to ensure the most beneficial outcomes.
Materials and methods