Our son was born through gestational surrogacy in the USA. This was after a six-year infertility journey. During that time, we suffered three heart breaking pregnancy losses.

It’s estimated that 15 per cent of confirmed pregnancies end in miscarriage. Yet from talking to my friends, I would say the number is higher. And whether the pregnancy happened naturally or through fertility treatment, after a month of trying to conceive or after years, or whether the baby passed at 5 weeks or 12 weeks, it really doesn’t matter. A loss is a loss. In my experience, it’s a suffering that doesn’t compare to anything else. It rips you open and leaves you feeling devastated, confused, and sometimes even guilty. You can feel at peace with it one day and then without any warning, feel a tidal wave of grief the next.

Our first pregnancy loss was due to an ectopic pregnancy. Our second loss was a missed miscarriage. And our third miscarriage was with our surrogate Leigha and was due to a sub chronic haematoma. I remember after our second loss, I was consumed with trying to work out what had happened. The first thing I learned is that it’s not your fault. I once read an inspiring Instagram post by the actor James Van Der Beek (Dawson’s Creek). He was honest and vulnerable about the multiple miscarriages he and his wife had endured. But what really stood out was his refreshing take on the word miscarriage itself. He wrote, “First off—we need a new word for it. ‘Miscarriage’, in an insidious way, suggests fault of the mother—as if she dropped something, or failed to ‘carry’. From what I’ve learned, in all but the most obvious, extreme cases, it has nothing to do with anything the mother did or didn’t do. So, let’s wipe all blame off the table before we even start”. Spot on.

The second thing I learned is that most miscarriages are due to genetic abnormalities. And this is where Preimplantation Genetic Testing (PGT) is invaluable. PGT tests if your embryos are genetically normal. There are different types of PGT, but the most common test is PGT-A. This test screens embryos to ensure they have the correct number and order of chromosomes—this includes twenty-three pairs of chromosomes. If a chromosome is missing or duplicated, an embryo won’t implant. Or if it does implant, you will miscarry. Given chromosome abnormalities are the cause of most miscarriages, PGT-A is said to decrease the miscarriage rate by a staggering fifty per cent. Also, a pregnancy rate on a PGT-A cycle is estimated to be sixty to seventy per cent, compared to approximately thirty per cent for a cycle without it.

There’s also an added benefit of PGT-A, it can screen for gender. If an embryo has XX sex chromosomes, it’s a female. If it has XY chromosomes, it’s a male. For us, this wasn’t an option. Even though our surrogacy transfers were in the USA, our embryos were created and genetically tested in Australia where it’s illegal to know the gender. But in the USA, it’s legal.

Prior to PGT, embryologists would assess an embryo’s quality through the ABC grading system. Many IVF clinics still use both methods in conjunction with one another. But this grading system alone is not reliable as it only assesses how an embryo looks on the outside. During our treatment, one of our embryologists compared the grading system to a book. A book can look perfect on the outside but once you open it, there could be a page or section missing. Or a page doubled up. This means the story is interrupted and doesn’t make sense to the reader. Or, in the case of an embryo, a chromosome is missing or duplicated and therefore it won’t be a viable pregnancy.

As mentioned, there are different types of PGT. To learn more about PGT, you can read the article:  Understanding Preimplantation Genetic Testing (PGT): Insights from Dr. Minoos Hosseinzadeh. Also, at Wish for a Baby Australia, there will be a seminar on genetic testing: ‘Genetic Testing and Fertility - What You Should Know’. And there will be IVF specialists on hand to talk to you about PGT and answer any questions you may have.