{"version":"1.0.0","segments":[{"startTime":0.895,"endTime":3.783,"body":"Today we talk about how could PGT"},{"startTime":3.919,"endTime":6.884,"body":"be so wrong? I'm, Dr. Mark"},{"startTime":6.916,"endTime":9.82,"body":"Amols and this is"},{"startTime":9.884,"endTime":12.288,"body":"Taco about Fertility Tuesday."},{"startTime":24.068,"endTime":26.99,"body":"Today we're talking about a topic that causes a lot of"},{"startTime":27.014,"endTime":29.75,"body":"confusion and sometimes unnecessary"},{"startTime":29.814,"endTime":32.358,"body":"fear. Preimlantation genetic"},{"startTime":32.398,"endTime":35.23,"body":"testing for anapodyy, also known as"},{"startTime":35.374,"endTime":37.098,"body":"pgta."},{"startTime":37.598,"endTime":40.35,"body":"Specifically why it seems like some"},{"startTime":40.374,"endTime":43.366,"body":"embryos labeled as abnormal have gone on to"},{"startTime":43.382,"endTime":46.31,"body":"have healthy babies. You may have"},{"startTime":46.334,"endTime":49.046,"body":"seen the headlines or heard stories claiming that"},{"startTime":49.102,"endTime":52.058,"body":"PGTA was so wrong at these"},{"startTime":52.098,"endTime":54.93,"body":"so called abnormal, embryos led to live births. So"},{"startTime":54.954,"endTime":57.626,"body":"what gives? Was PGTA"},{"startTime":57.762,"endTime":60.018,"body":"actually wrong or was the data just"},{"startTime":60.058,"endTime":62.778,"body":"misunderstood? Well, let's dive in this"},{"startTime":62.818,"endTime":65.518,"body":"episode and learn a little bit more about this."},{"startTime":66.058,"endTime":68.954,"body":"To truly understand this podcast, we're going to have to define some"},{"startTime":68.986,"endTime":71.674,"body":"terms. An anaploid embryo"},{"startTime":71.786,"endTime":74.778,"body":"has the wrong number of chromosomes in all"},{"startTime":74.898,"endTime":77.842,"body":"of its cells, and these are almost always"},{"startTime":77.89,"endTime":80.408,"body":"incompatible with a healthy pregnancy."},{"startTime":80.788,"endTime":83.652,"body":"A mosaic embryo, on the other hand, has a"},{"startTime":83.7,"endTime":86.604,"body":"mix. Some normal, some abnormal"},{"startTime":86.636,"endTime":89.556,"body":"cells. Think of it like baking a batch of"},{"startTime":89.572,"endTime":92.328,"body":"cookies. You mix everything together."},{"startTime":92.708,"endTime":95.604,"body":"But if a few pockets have too much salt or"},{"startTime":95.636,"endTime":98.428,"body":"not enough sugar, some mites will taste great,"},{"startTime":98.508,"endTime":101.276,"body":"while others might be slightly off. The"},{"startTime":101.292,"endTime":103.988,"body":"ingredients are all there, but not evenly"},{"startTime":104.028,"endTime":106.744,"body":"distributed. That's mosaiism."},{"startTime":106.936,"endTime":109.668,"body":"Some cells are normal, others aren't."},{"startTime":110.248,"endTime":113.152,"body":"All depending on how things were mixed in the early stages of"},{"startTime":113.2,"endTime":116.024,"body":"development. Now, I'm simplifying this a bit, because true"},{"startTime":116.056,"endTime":118.936,"body":"mosaicism can be everywhere."},{"startTime":119.032,"endTime":121.848,"body":"Where all the cells in the human body can have"},{"startTime":121.888,"endTime":124.84,"body":"mosaic DNA, where some of the DNA is"},{"startTime":124.864,"endTime":127.624,"body":"normal and some of the DNA is abnormal, like mosaic"},{"startTime":127.656,"endTime":130.512,"body":"turners. There are other situations where you can"},{"startTime":130.52,"endTime":133.236,"body":"have mosaic, where the placenta"},{"startTime":133.372,"endTime":136.324,"body":"has one type of DNA and then in"},{"startTime":136.356,"endTime":139.356,"body":"the embryo it's different. The point is, when"},{"startTime":139.372,"endTime":142.364,"body":"you look at a mosaic embryo, you almost have to think of it"},{"startTime":142.396,"endTime":145.388,"body":"having three states. The first state would be a"},{"startTime":145.428,"endTime":148.34,"body":"completely normal embryo, but when they took the"},{"startTime":148.364,"endTime":151.26,"body":"biopsy, they got some abnormal cells and so"},{"startTime":151.284,"endTime":154.284,"body":"it looks like the embryo is mosaic. The other"},{"startTime":154.316,"endTime":157.036,"body":"state would be if the embryo abnormal. And when they took the"},{"startTime":157.052,"endTime":159.902,"body":"biopsy, they got some normal cells and now the embryo"},{"startTime":159.95,"endTime":162.83,"body":"looks mosaic. And then the third state would"},{"startTime":162.854,"endTime":165.606,"body":"be a truly mosaic embryo where every cell"},{"startTime":165.702,"endTime":168.622,"body":"in the embryo has the mosaic DNA."},{"startTime":168.79,"endTime":171.518,"body":"Now, over the years, PGT has evolved."},{"startTime":171.678,"endTime":173.966,"body":"In the very beginning we used what's called"},{"startTime":174.062,"endTime":176.558,"body":"fish fluorescent in Sittu"},{"startTime":176.638,"endTime":179.502,"body":"hybridization. And that is not really"},{"startTime":179.55,"endTime":182.222,"body":"used anymore because basically what they would do"},{"startTime":182.39,"endTime":184.818,"body":"is you would take a probe that would then"},{"startTime":185.248,"endTime":188.216,"body":"go to the chromosomes and attach and then it would light up with a"},{"startTime":188.232,"endTime":191.176,"body":"certain color and would let you know if something is There is not."},{"startTime":191.312,"endTime":193.272,"body":"That methodology cannot detect"},{"startTime":193.36,"endTime":196.272,"body":"roaicism. After that came"},{"startTime":196.44,"endTime":199.32,"body":"array cgh, which stands for"},{"startTime":199.384,"endTime":201.948,"body":"array Comparative Genomic hybridization."},{"startTime":202.408,"endTime":205.272,"body":"Much better than fish, but had a"},{"startTime":205.32,"endTime":208.176,"body":"low sensitivity to detect mosaicism, especially"},{"startTime":208.232,"endTime":210.874,"body":"any type of osaicism thats under 40%."},{"startTime":211.016,"endTime":213.758,"body":"So a lot of things were called abnormal,"},{"startTime":213.798,"endTime":216.07,"body":"meaning anaploid, even though it might have had"},{"startTime":216.094,"endTime":218.854,"body":"mosaicism. Part of the issue with this method is it could"},{"startTime":218.886,"endTime":221.822,"body":"not quantify the portion of abnormal cells. So it was more"},{"startTime":221.83,"endTime":224.738,"body":"of like a it'either there or not there type of readout."},{"startTime":225.158,"endTime":227.99,"body":"SNP arrays that came around were a little bit better"},{"startTime":228.054,"endTime":230.894,"body":"than array CGH at detectiveonaiitn"},{"startTime":230.926,"endTime":233.646,"body":"but they still struggled with quantifying the percentage of"},{"startTime":233.662,"endTime":236.454,"body":"abnormal cells. This means that some embryos were"},{"startTime":236.486,"endTime":239.31,"body":"called abnormal mean and deployed when in reality"},{"startTime":239.374,"endTime":242.278,"body":"they could have been normal. Then came NGS"},{"startTime":242.398,"endTime":245.238,"body":"next generation sequencing. This is now the gold"},{"startTime":245.278,"endTime":248.182,"body":"standard for mosaicism. It can detect and quantify"},{"startTime":248.27,"endTime":250.654,"body":"the mosaic system down to about 20 to"},{"startTime":250.686,"endTime":253.478,"body":"30%. There are times it can even be lower with certain"},{"startTime":253.518,"endTime":256.126,"body":"platforms. Now labs take that"},{"startTime":256.222,"endTime":259.126,"body":"gradient and say okay, if it's under 20%"},{"startTime":259.302,"endTime":262.086,"body":"abnormal then they're going to call it upoid. If"},{"startTime":262.102,"endTime":264.982,"body":"it's 20 to 40% abnormal, they call it low level"},{"startTime":265.03,"endTime":267.778,"body":"mosaic, 40 to 80% high level"},{"startTime":267.818,"endTime":270.594,"body":"mosaic. And if over 80% of the cells"},{"startTime":270.746,"endTime":273.594,"body":"show anaploidy then they call it anaploid. But the question is"},{"startTime":273.626,"endTime":276.594,"body":"how did they get to this state? When did someone"},{"startTime":276.626,"endTime":279.506,"body":"start calling them mosaic? When? Before"},{"startTime":279.562,"endTime":282.346,"body":"it was either euloid or unemloed? Well before"},{"startTime":282.442,"endTime":284.89,"body":"2015 everything just got lumped into"},{"startTime":284.994,"endTime":287.746,"body":"Andloyed. In 2015 there were some"},{"startTime":287.802,"endTime":290.65,"body":"reports that some embryos labeled as antaploed by"},{"startTime":290.674,"endTime":293.498,"body":"PGTA still led to healthy birds. That sounds"},{"startTime":293.538,"endTime":296.17,"body":"amazing, right? But when those embr were actually"},{"startTime":296.234,"endTime":299.226,"body":"analyzed closely, what they found was they were actually"},{"startTime":299.282,"endTime":302.078,"body":"mosaic embryos and not truly anemloed."},{"startTime":302.418,"endTime":304.93,"body":"The problem wasnt the test, it was that the"},{"startTime":304.954,"endTime":307.93,"body":"mosaic system wasnt fully recognized and"},{"startTime":307.954,"endTime":310.93,"body":"was reported at that time as being"},{"startTime":310.994,"endTime":313.85,"body":"unemoyed, even though it was incorrect. Now what you will"},{"startTime":313.874,"endTime":316.85,"body":"hear is people will say oh yes, your abnormal embryos will"},{"startTime":316.874,"endTime":319.846,"body":"lead to live births. But this was based on studies in"},{"startTime":319.862,"endTime":322.43,"body":"the past that looked at embryos that were lumped into"},{"startTime":322.454,"endTime":324.942,"body":"anaploid even though they weren't"},{"startTime":325.03,"endTime":328.014,"body":"anaploid, they were mosaic. So now we fast forward"},{"startTime":328.046,"endTime":331.03,"body":"to today and now we have much better data, especially"},{"startTime":331.054,"endTime":333.95,"body":"from large blinded studies. One of the most"},{"startTime":334.014,"endTime":336.878,"body":"striking studies looked at over 100 embryos"},{"startTime":336.918,"endTime":339.838,"body":"labeled as truly antapodied using modern"},{"startTime":339.878,"endTime":342.058,"body":"next day generation sequencing"},{"startTime":342.598,"endTime":345.352,"body":"found that not one of them led to a Live"},{"startTime":345.4,"endTime":348.264,"body":"birth. Now, somei implanted and may"},{"startTime":348.296,"endTime":351.117,"body":"even started to go into heartbeat, or something like that. But"},{"startTime":351.125,"endTime":353.869,"body":"then eventually it failed. It"},{"startTime":353.901,"endTime":356.821,"body":"had zero percent sustained success."},{"startTime":356.957,"endTime":359.493,"body":"Now this study was really important because what it did"},{"startTime":359.533,"endTime":362.525,"body":"was, is they tested all of the embryos with"},{"startTime":362.549,"endTime":365.153,"body":"pgta, but they didn't look at the results."},{"startTime":365.493,"endTime":368.341,"body":"And then they went and they transferred this into patients and"},{"startTime":368.357,"endTime":371.197,"body":"then later unblinded the results to find out"},{"startTime":371.245,"endTime":373.621,"body":"which embryos were euloid, which ones were"},{"startTime":373.637,"endTime":376.397,"body":"unaploid, which ones were mosaic, and"},{"startTime":376.445,"endTime":378.953,"body":"what happened. And in that study,"},{"startTime":379.333,"endTime":382.181,"body":"none of them that were anaploid led to a"},{"startTime":382.197,"endTime":385.133,"body":"live birth. Now if you compare that the mosaic"},{"startTime":385.173,"endTime":387.973,"body":"embryos, which, depending on the degree of the"},{"startTime":388.013,"endTime":390.661,"body":"mosaic system, some did leave the"},{"startTime":390.677,"endTime":393.525,"body":"liveerss 30 to 50% of the time. So what this tells"},{"startTime":393.549,"endTime":396.221,"body":"us is the misclassified embryos as"},{"startTime":396.277,"endTime":399.169,"body":"anaploid instead of mosaic is what led"},{"startTime":399.201,"endTime":401.825,"body":"to in the past abnormal embryos becoming"},{"startTime":402.009,"endTime":404.889,"body":"live birth. Now, it's important to understand it's"},{"startTime":404.921,"endTime":407.801,"body":"not that they were wrong, it's just at that time we didn't"},{"startTime":407.857,"endTime":410.409,"body":"realize this methods like array,"},{"startTime":410.441,"endTime":413.241,"body":"CGH and snip arrays didn't have the resolution to"},{"startTime":413.257,"endTime":416.057,"body":"detect mosaicism very well. So unfortunately"},{"startTime":416.105,"endTime":418.97,"body":"these were called abnormal, being anemloed and were not"},{"startTime":419.018,"endTime":421.954,"body":"transferred. When next gen sequencing came around, it changed the"},{"startTime":421.97,"endTime":424.602,"body":"game. It can detect these subtle"},{"startTime":424.714,"endTime":427.446,"body":"ships and give a much more accurate picture."},{"startTime":427.566,"endTime":430.342,"body":"So we can determine if the embryo might just have a couple"},{"startTime":430.454,"endTime":433.286,"body":"abnormal cells in it versus the whole embryo"},{"startTime":433.326,"endTime":436.086,"body":"being abnormal. And it's not stopping there."},{"startTime":436.206,"endTime":438.95,"body":"Matter of fact, Cooper Genomics has gone even further"},{"startTime":438.998,"endTime":441.974,"body":"recently. They now preserve the original"},{"startTime":442.03,"endTime":444.694,"body":"DNA rather than just making copies of the DNA."},{"startTime":444.83,"endTime":447.566,"body":"So when you get the sample, you have to amplify it with"},{"startTime":447.606,"endTime":450.438,"body":"whole genome amplification, but you keep"},{"startTime":450.462,"endTime":453.342,"body":"making copies of copies. So now they have a technique"},{"startTime":453.494,"endTime":456.462,"body":"that actually uses the original DNA, which then lowers"},{"startTime":456.614,"endTime":459.19,"body":"the noise in the data so you can get better"},{"startTime":459.238,"endTime":461.654,"body":"resolution. They also now are integrating"},{"startTime":461.75,"endTime":464.278,"body":"SNPs into the analysis, which then allows them to look"},{"startTime":464.302,"endTime":466.95,"body":"at other things such as copy"},{"startTime":466.998,"endTime":469.646,"body":"number so they can rulel out conditions like triploidy"},{"startTime":469.806,"endTime":472.774,"body":"and to detect uniportal disysamey. This"},{"startTime":472.79,"endTime":475.718,"body":"is when both copies of the DNA came from"},{"startTime":475.742,"endTime":478.678,"body":"the same parent. So it looks like both came"},{"startTime":478.702,"endTime":481.534,"body":"from one from the mom and one from the dad, but in this situation"},{"startTime":481.71,"endTime":484.414,"body":"it's from the same parent. Now it's important to understand that"},{"startTime":484.47,"endTime":487.342,"body":"adding the SNPs doesn't really directly improve the most sacism"},{"startTime":487.374,"endTime":489.758,"body":"detection, but it does help route those other"},{"startTime":489.782,"endTime":492.454,"body":"conditions. The point is we haven't stopped"},{"startTime":492.51,"endTime":495.478,"body":"looking and we're always trying to get better. So here's the"},{"startTime":495.502,"endTime":498.262,"body":"kicker. Even with next Gen sequencing,"},{"startTime":498.374,"endTime":501.341,"body":"we can't reliably detectostaicism, below about 20%."},{"startTime":501.397,"endTime":503.429,"body":"And the question is why?"},{"startTime":503.621,"endTime":506.549,"body":"Well, we're only sampling a few cells,"},{"startTime":506.701,"endTime":509.515,"body":"five to ten cells at most. And Emboryo"},{"startTime":509.539,"endTime":512.267,"body":"has hundreds of cells. So if you biopsy five"},{"startTime":512.315,"endTime":515.267,"body":"cells and one cell is abnormal, that's only"},{"startTime":515.315,"endTime":518.211,"body":"20%. And this is the problem. We expect it to"},{"startTime":518.227,"endTime":521.227,"body":"be uniform throughout, but it's not. We wish it"},{"startTime":521.235,"endTime":524.099,"body":"was reflective of the whole embryo, but we know it can't always"},{"startTime":524.131,"endTime":526.699,"body":"be. It would be like taking one bite"},{"startTime":526.891,"endTime":529.667,"body":"of a great taco and you think that's going to"},{"startTime":529.715,"endTime":532.365,"body":"represent the whole taco. But, on that bite, they messed"},{"startTime":532.389,"endTime":535.165,"body":"up. I put too much sour cream and guac on"},{"startTime":535.189,"endTime":537.603,"body":"one side, barely any meat, and you're like, this is"},{"startTime":537.643,"endTime":540.451,"body":"disgusting. But what you don't know is the rest of that taco"},{"startTime":540.467,"endTime":543.435,"body":"is amazing. Unfortunately, it wasn't distributed and"},{"startTime":543.459,"endTime":546.227,"body":"your biopsy was only a small portion"},{"startTime":546.315,"endTime":549.219,"body":"of the entire taco. So the sampling of a few"},{"startTime":549.251,"endTime":551.699,"body":"cells like that is not reflective of the whole"},{"startTime":551.731,"endTime":554.715,"body":"picture. Add to that the noise that's"},{"startTime":554.819,"endTime":556.943,"body":"introduced by DNA amplification."},{"startTime":557.523,"endTime":560.331,"body":"Noise is when you have all this data, it's all over the"},{"startTime":560.347,"endTime":563.131,"body":"place and you have to eventually smooth it"},{"startTime":563.147,"endTime":566.011,"body":"out. If there are too many outliers in the data, then you"},{"startTime":566.027,"endTime":568.531,"body":"can't utilize the data. But there are some"},{"startTime":568.547,"endTime":571.243,"body":"outliers and usually what happens is those are kind of thrown"},{"startTime":571.283,"endTime":574.139,"body":"out. But if it becomes too noisy, you"},{"startTime":574.171,"endTime":576.563,"body":"can't distinguish the actual"},{"startTime":576.683,"endTime":579.675,"body":"DNA from the noise. Think of it as technical"},{"startTime":579.739,"endTime":582.691,"body":"background noise. So the 20%"},{"startTime":582.867,"endTime":585.515,"body":"is kind of the limit currently that people believe"},{"startTime":585.539,"endTime":588.539,"body":"in because they feel that has a good representation of"},{"startTime":588.571,"endTime":591.247,"body":"not tossing to my embryos, but not"},{"startTime":591.295,"endTime":594.175,"body":"overalling as well. And this brings us to"},{"startTime":594.199,"endTime":596.083,"body":"one of the biggest points."},{"startTime":596.743,"endTime":599.711,"body":"Patient fear. What if we'discarding"},{"startTime":599.767,"endTime":602.003,"body":"healthy embryos because of pgta?"},{"startTime":602.623,"endTime":605.327,"body":"Well, heres the reassuring truth. The"},{"startTime":605.375,"endTime":608.144,"body":"likelihood of discarding a, truly healthy embryo"},{"startTime":608.232,"endTime":611.22,"body":"labeled as anaploidy is extremely low."},{"startTime":612.04,"endTime":614.94,"body":"Modern PGTA is very accurate."},{"startTime":615.31,"endTime":617.942,"body":"If your embryo is labeled as anapoyid by NGS and"},{"startTime":618.006,"endTime":620.998,"body":"confirm not to be mosaic, the chance of resulting in a"},{"startTime":621.014,"endTime":623.656,"body":"healthy baby are, near zero. There are"},{"startTime":623.712,"endTime":626.428,"body":"multiple prospective studies that confirm this now."},{"startTime":626.968,"endTime":629.188,"body":"So how could it be so wrong? In the past,"},{"startTime":629.888,"endTime":632.72,"body":"because there were some early missislassifications."},{"startTime":632.904,"endTime":635.872,"body":"But now that we understand mosaicism, the"},{"startTime":635.96,"endTime":638.88,"body":"technology and reporting have caught up. Your clinic"},{"startTime":638.944,"endTime":641.292,"body":"should be differentiating between mosaic,"},{"startTime":641.44,"endTime":644.14,"body":"segmental and full anapoy. And if they"},{"startTime":644.164,"endTime":646.088,"body":"are, you can feel pretty"},{"startTime":646.428,"endTime":649.324,"body":"Reassured that the likelihood of discarding a"},{"startTime":649.356,"endTime":652.116,"body":"truly healthy embryo is near zero."},{"startTime":652.252,"endTime":655.156,"body":"This doesn'mean things may not get better. We may learn things"},{"startTime":655.212,"endTime":658.1,"body":"even later. But the one part we do know is"},{"startTime":658.124,"endTime":661.02,"body":"when you look at blinded testing where"},{"startTime":661.044,"endTime":663.948,"body":"they didn't know whether the was normal or not, they"},{"startTime":663.988,"endTime":666.768,"body":"did not see live birds with the truly"},{"startTime":667.088,"endTime":670.0,"body":"full anemloidy embryos. So back to the"},{"startTime":670.024,"endTime":672.68,"body":"main question. How could PGT"},{"startTime":672.824,"endTime":675.536,"body":"be so wrong? The answer is"},{"startTime":675.712,"endTime":678.392,"body":"it wasn't. The test wasn't"},{"startTime":678.44,"endTime":681.028,"body":"flawed. The interpretation was."},{"startTime":681.528,"endTime":684.528,"body":"When we saw anaploed labeled embryos led to"},{"startTime":684.568,"endTime":687.392,"body":"libie bir we thought we had proof that PGT"},{"startTime":687.44,"endTime":690.033,"body":"was wrong. But what we really had were,"},{"startTime":690.01,"endTime":692.7,"body":"mosaic embryos hiding in plain sight."},{"startTime":692.882,"endTime":695.36,"body":"We thought they were abnormal leading to live"},{"startTime":695.392,"endTime":698.044,"body":"birth, but they were never abnormal to begin with."},{"startTime":699.144,"endTime":701.864,"body":"Like all tools, PGTA is"},{"startTime":701.904,"endTime":704.272,"body":"powerful, but it needs to be used and"},{"startTime":704.328,"endTime":707.328,"body":"understood properly. Now that we know how to"},{"startTime":707.376,"endTime":710.088,"body":"interpret mosaiism, we're better than ever"},{"startTime":710.176,"endTime":712.608,"body":"identifying embryos that have a true shot"},{"startTime":712.656,"endTime":714.684,"body":"becoming your healthy baby."},{"startTime":715.304,"endTime":717.984,"body":"So trust the process, but always ask"},{"startTime":718.104,"endTime":720.726,"body":"questions. Make sure your clinic"},{"startTime":720.83,"endTime":723.75,"body":"is using the most up to date methods and"},{"startTime":723.782,"endTime":726.51,"body":"language when it comes to categorizing"},{"startTime":726.542,"endTime":729.51,"body":"embryos. And the reason for that is if they are"},{"startTime":729.542,"endTime":732.078,"body":"not categorizing the embryos correctly,"},{"startTime":732.246,"endTime":735.03,"body":"then yes, it is possible that you are"},{"startTime":735.062,"endTime":737.854,"body":"throwing away embryos that could lead to a live birth."},{"startTime":738.014,"endTime":740.854,"body":"If they are being called anaploid and they"},{"startTime":740.854,"endTime":743.758,"body":"are actually mosaic embryos. Maybe youe re"},{"startTime":743.766,"endTime":746.354,"body":"like a lot of people who have been wondering for some time,"},{"startTime":746.764,"endTime":749.624,"body":"am I throwing away normal embryos?"},{"startTime":750.004,"endTime":752.876,"body":"Maybe if you've been in those fors where people say, oh, I've heard"},{"startTime":752.9,"endTime":755.58,"body":"of people getting pregnant with anaploid"},{"startTime":755.612,"endTime":758.476,"body":"embryos. But now you know, you don't have to be as"},{"startTime":758.5,"endTime":761.492,"body":"fearful because what the studies show is, is"},{"startTime":761.508,"endTime":764.484,"body":"that if you look at mosaicism and you're putting"},{"startTime":764.524,"endTime":767.524,"body":"back full anaploid embryos, it's"},{"startTime":767.564,"endTime":770.276,"body":"not going to lead to a live birth. Sure,"},{"startTime":770.42,"endTime":773.14,"body":"there might be one case every once in a blue moon that may"},{"startTime":773.172,"endTime":775.87,"body":"happen, but that is the outlier and that is the"},{"startTime":775.902,"endTime":778.75,"body":"rarity. When I say rarity, I mean saying almost"},{"startTime":778.822,"endTime":781.798,"body":"zero. If you hear someone getting pregnant with an abnormal embryo,"},{"startTime":781.886,"endTime":784.878,"body":"there's a good chance it wasn't abnormal, but that was"},{"startTime":784.926,"endTime":787.67,"body":"classified wrong. And you should feel confident"},{"startTime":787.782,"endTime":790.59,"body":"that you're not throwing away healthy embryos"},{"startTime":790.702,"endTime":793.31,"body":"as long as your clinic is classifying"},{"startTime":793.422,"endTime":795.862,"body":"both euloid andlooid"},{"startTime":795.998,"endTime":798.902,"body":"and mosaic embryos. I"},{"startTime":798.918,"endTime":801.746,"body":"think this is a really important topic and I really hope"},{"startTime":801.77,"endTime":804.642,"body":"you pass this along to other people. I think there's a lot of"},{"startTime":804.658,"endTime":807.186,"body":"misinformation out there about how PGT can be"},{"startTime":807.21,"endTime":810.106,"body":"wrong. And I agree that there might be"},{"startTime":810.21,"endTime":813.17,"body":"the appearance of it being wrong. But as you heard in this"},{"startTime":813.202,"endTime":815.73,"body":"podcast, it's not that PGT was"},{"startTime":815.762,"endTime":818.722,"body":"wrong, it's how it was interpreted. If you liked"},{"startTime":818.738,"endTime":821.626,"body":"this episode, please share it with a friend. And as I always say,"},{"startTime":821.69,"endTime":824.37,"body":"if you like the show, give us a five star review on your favorite"},{"startTime":824.402,"endTime":827.026,"body":"medium. But most of all, keep coming back."},{"startTime":827.21,"endTime":829.962,"body":"I look forward to talking you again next week on Talk"},{"startTime":830.018,"endTime":831.154,"body":"About Fertility Tuesday."}]}