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Ensure your baby's health (even before pregnancy)

Preimplantation genetic diagnosis provides couples the opportunity to combat birth defects.

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The Gulf region faces certain health obstacles when it comes to consanguineous marriages. Although marriages between relatives play a strong cultural tradition, they can also cause severe birth defects, as parents who are cousins have more than double the risk of conceiving a child with congenital abnormalities.
However, modern science and technology is now giving couples the opportunity to combat birth defects, though preimplantation genetic diagnosis (PGD), although insurances are yet to support such treatments.
The genetic diagnosis, which can be seen as a clinical breakthrough, takes place before pregnancy begins, and helps identify diseased embryos prior to conception.
Dr Michael Fakih, reproductive endocrinologist and fertility consultant and chairman of Fakih IVF Fertility Centre in UAE, (which introduced the very first EmbryoScope to the country), IVF Michigan and the founder of the first IVF centre in Lebanon, spoke to Khaleej Times on how genetic diagnosis can ultimately save lives of future generations.

Preimplantation genetic diagnosis, explained The scientific breakthrough of preimplantation genetic diagnosis (PGD) is providing couples in the UAE - with a history of genetic disorders - to conceive healthy and disease-free children. Dr Monika Chawla, reproductive endocrinologist and fertility specialist at Fakih IVF Fertility Centre in Abu Dhabi, told Khaleej Times that the treatment is crucial for couples hoping to conceive a healthy child, especially when it comes to consanguineous marriages, as it helps avoid congenital abnormalities. "The abnormalities can range from relatively minor problems, such as extra fingers or toes, to major life-threatening diseases, such as holes in the heart or brain development disorders." PGD, which takes place before pregnancy, begins with the process of in vitro fertilisation. The process involves taking the eggs from the woman's body and fertilising them in a laboratory. After three days, the embryo divides into a cluster, which then has one or two cells removed in a biopsy. The removed cells are then evaluated to determine if the inheritance of the problematic gene is present in the embryo. The implantation takes place once the embryos are free of genetic problems, which is then placed in the uterus. RFakih IVF also recently identified rare cancer genes (BRAC-1 and 2), which leads to a 70-80 per cent risk of breast cancer, causing women to undergo mutilating surgery for the removal of the breasts at a young age, to prevent the cancer from developing. Dr Chawla noted that cancer could thus be avoided prior to conception, by identifying the high-risk gene in the embryos and then implanting only embryos with low cancer risk. The centre has recently enabled one of five such PGD-undergone pregnancies, which is a huge breakthrough for reproductive health. Dr Chawla, whose research work has been published in 27 international journals, noted that there is always a light at the end of the tunnel for couples who are afraid of passing their disease to their next generation. "Couples have the opportunity to have healthy babies, despite the fact that they never had disease-free children in their lives." The IVF treatments start from approximately Dh20,000, excluding the drugs, while PGD can cost roughly Dh10,000 - Dh15,000 extra. A price, which can be described as priceless when it comes to having a healthy child. jasmine@khaleejtimes.com

Dr Fakih, who is responsible for more than 12,000 successful IVF deliveries, highlighted that couples are able to curb birth defects, which can be detected by simple blood tests.
"Before couples get married in the UAE, they undergo a blood test to rule out infections and diseases such as thalassaemia, which is commonly found in the region."
"Sometimes however, a disease is found and it makes it difficult for the couple to conceive a healthy, disease-free child."
He pointed out that there are more than 300 common genetic diseases that are often caused by consanguineous marriages. Genetic diagnosis can thus help eliminate any genetic diseases that might be carried on to the next generation.
Besides the health and social aspect of how the treatment can help the couple create a disease-free child, it will also eliminate the lifelong financial burden they will carry to sustain a decent living for a disabled child.
Dr Fakih, who is also an associate professor at Michigan State University, College of Human Medicine, noted that children suffering from severe mental or physical disabilities often travel abroad for expensive treatments, require costly drugs special assistance at home, and are put in special schools.
Although the treatment is helping couples in the UAE, he pointed out that thousands of more couples would benefit if insurance companies can simply cover the costs.
"If a little bit of money is invested in these critical tests, it can help overrule the other 99 per cent of cost that is spent on sustaining a child living with a disability.
"We can really eliminate future genetic disorders if insurances can spend a little bit more to help countless families.
"The prevention is what is important, because once you have one Emirati child with a disease, it automatically costs the government Dh100 million. But if we can invest in the treatment prior to conception, then we can prevent these large costs and eradicate these diseases."
Dr Monika Chawla, reproductive endocrinologist and fertility specialist at Fakih IVF Fertility Centre, explained that each couple is assessed and a treatment plan is then designed especially for them.
"IVF plays a crucial role when it comes to taking care of deformity in the region; infertility has gone up, and according to the Dubai Health Authority the rate is between 30 and 50 per cent."
She pointed out that genetic disorders are also on the rise in the UAE, which include thalassaemia, sickle cells and muscular dystrophy.
"Consanguinity, which is peculiar in the region, often causes rare disorders. We get couples who already have children carrying diseases and can barely lead a good quality life. But we can now detect and bypass these diseases through PGD."
jasmine@khaleejtimes.com