PGT testing - Pros and cons

[Anonymous]

What are the advantages/disadvantages of doing/foregoing PGT-A testing?

We didn't do it for our first cycle (fresh transfer + FET). I had 17 mature eggs, 13 fertilized, 4 made it to the embryo stage. But none resulted in pregnancy.
Our doc is saying she would try the same routine again, since she was very happy with the results (for an older woman, I am almost 42). Suggested we might want to do the PGT testing this cycle to ensure that we only transfer the normal ones. But what are the chances all normal embryos will result in a positive result? Anyone had successful results with transferring abnormal ones, if at all they transfer them?

We want to be as informed as possible before we go to the next stage, mainly because the PGT testing isn't cheap (an out of pocket expense). And we have nearly maxed out on our insurance coverage with the first cycle. We are with SGF, btw.
Thanks for sharing your experiences/suggestions.

[Anonymous]

At 42 I would definitely test. I’m surprised SG hasn’t more strongly recommend that. They won’t transfer abnormal embryos though so if that is all you get you will have to do another retrieval. We are very glad we tested.

[Anonymous]

I wasn't clear if the embryo stage is day 3 or day 5. If you can't make blasts or only make 1 or 2 per cycle, it doesn't pay to test, because of the false positive rate and/or damage to the embryo. PGT testing helps when you have a lot of blasts and need to chose the best ones.

[Anonymous]

Anonymous wrote:At 42 I would definitely test. I’m surprised SG hasn’t more strongly recommend that. They won’t transfer abnormal embryos though so if that is all you get you will have to do another retrieval. We are very glad we tested.

We are considering the testing this time around.
But also thinking what are the odds that an abnormal embryos will result in a pregnancy, in case we decide to forego testing.

[Anonymous]

Anonymous wrote:I wasn't clear if the embryo stage is day 3 or day 5. If you can't make blasts or only make 1 or 2 per cycle, it doesn't pay to test, because of the false positive rate and/or damage to the embryo. PGT testing helps when you have a lot of blasts and need to chose the best ones.

So far we have had just 1 cycle (fresh transfer and a FET).
Four blasts in that cycle, day 5

[Anonymous]

41 and don’t make any blasts (everything arrests after day 3). My 5 year old DD was a day 3 transfer. Currently 16 weeks after a transfer of my first blast ever, untested due to the false positives and potential embryo damage. If you make enough blasts i would test, I didn’t have that luxury

[Anonymous]

Tough call. I'd lean towards not testing so you have more $$ for more IVF cycles. If you think about it, PGS cannot create a normal embryo from a batch of abnormals. In that way it cannot increase your chances as long as you are willing to chug through all the embryos with FETs. The only way it could increase your chance is if you are in danger of "burning out" and not transferring all the embryos you get.

Would your doctor transfer 2 day 3s?

[Anonymous]

We didn't PGS even though we got 8 embryos under the rationale that the biopsying process can't possibly improve the embryo and the RE said an untested blast has a 40% chance while the normal is 65%.

[Anonymous]

I am very similar to you - one cycle this summer at 42, I made 6 blasts. Sent them to testing and glad I did because I only got one normal, and that could have been a tremendous waste of time and heartache. Also m/c can have complications that further diminish fertility! Also I have read EVERYTHING and I think the shortcomings of PGT are somewhat overstated and really only apply to edge cases. I think on the whole it’s pretty good at sorting amongst blasts.

[Anonymous]

Anonymous wrote:Tough call. I'd lean towards not testing so you have more $$ for more IVF cycles. If you think about it, PGS cannot create a normal embryo from a batch of abnormals. In that way it cannot increase your chances as long as you are willing to chug through all the embryos with FETs. The only way it could increase your chance is if you are in danger of "burning out" and not transferring all the embryos you get.

Would your doctor transfer 2 day 3s?

DH also says the same thing you're saying - that the test cannot create a normal embryo from an abnormal batch. And if we get no normals, then what next? Also we are trying to gather info about the results of transferring an abnormal embryo, so to say. Whether it has resulted in a pregnancy and a healthy birth, or produced opposite results.

[Anonymous]

Anonymous wrote:I am very similar to you - one cycle this summer at 42, I made 6 blasts. Sent them to testing and glad I did because I only got one normal, and that could have been a tremendous waste of time and heartache. Also m/c can have complications that further diminish fertility! Also I have read EVERYTHING and I think the shortcomings of PGT are somewhat overstated and really only apply to edge cases. I think on the whole it’s pretty good at sorting amongst blasts.

M/C? Sorry for the silly question, I'm trying to learn all I can
Assuming they transferred the normal one for you, if you don't mind me asking, how did it go?

Also, I'd love it if you can share resources on the shortcomings of PGT, and applying to edge cases.
We're still on the fence, but with a better informed idea about transfers of abnormal ones and their results, I think we'll be able to put all cards on the table and decide.
The main reason being - if an abnormal one has resulted in a normal pregnancy, should we take the chance as well?

Thanks one again for sharing your experience.

[Anonymous]

Anonymous wrote:We didn't PGS even though we got 8 embryos under the rationale that the biopsying process can't possibly improve the embryo and the RE said an untested blast has a 40% chance while the normal is 65%.

How did your transfer(s) go, if you don't mind me asking?

[Anonymous]

Anonymous wrote:41 and don’t make any blasts (everything arrests after day 3). My 5 year old DD was a day 3 transfer. Currently 16 weeks after a transfer of my first blast ever, untested due to the false positives and potential embryo damage. If you make enough blasts i would test, I didn’t have that luxury

Oh wow, congratulations!
We are still undecided yet. Wondering if we get no normal ones after testing, can the abnormal ones be transferred, just in case they work out?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Tough call. I'd lean towards not testing so you have more $$ for more IVF cycles. If you think about it, PGS cannot create a normal embryo from a batch of abnormals. In that way it cannot increase your chances as long as you are willing to chug through all the embryos with FETs. The only way it could increase your chance is if you are in danger of "burning out" and not transferring all the embryos you get.

Would your doctor transfer 2 day 3s?

DH also says the same thing you're saying - that the test cannot create a normal embryo from an abnormal batch. And if we get no normals, then what next? Also we are trying to gather info about the results of transferring an abnormal embryo, so to say. Whether it has resulted in a pregnancy and a healthy birth, or produced opposite results.

I don't understand the thinking that "a test can't create a normal embryo, so why test." The point of testing is so that you don't put your body and mind through the stress of multiple FETs and potentially devastating miscarriages or terminations for medical reasons (TMFR - you will see this acronym on various infertility boards). You also won't waste more months of your rapidly waning fertile years going through months of useless FETs when you could be doing more egg retrievals in hopes of finding a good one. I am not unsympathetic, OP, I did six rounds of IVF over ages 41-42 and the drop-off over that time period in both eggs retrieved and their quality was striking. PGT testing is a really pretty small cost compared to the IVF process as a whole - and NO amount of money can buy back the time you may lose with repeated FETs of untested, ultimately non-viable embryos.

Also one popular argument against testing I hear a lot is people saying they would welcome a child with Down Syndrome anyway, for instance. But what about one with an abnormality that doesn't necessarily prevent a full-term pregnancy but is incompatible with life, e.g. Trisomy 13 or 18? That's another thing to think about. I know there is a lot of talk in some circles these days about how abnormal embryos might somehow correct themselves. I think that's highly unlikely at best and frankly suspect there are some pro-lifers at work in those conversations who are not concerned with the mother's (or father's) mental, physical, and financial stressors at all. At 42, I would absolutely test all your embryos if you're able to get them to blast stage.

Whatever path you take, I wish you good luck. It's a hard road but there really is a lot of wonderful stuff medical science can do these days. Fingers crossed for a healthy baby for you, OP!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Tough call. I'd lean towards not testing so you have more $$ for more IVF cycles. If you think about it, PGS cannot create a normal embryo from a batch of abnormals. In that way it cannot increase your chances as long as you are willing to chug through all the embryos with FETs. The only way it could increase your chance is if you are in danger of "burning out" and not transferring all the embryos you get.

Would your doctor transfer 2 day 3s?

DH also says the same thing you're saying - that the test cannot create a normal embryo from an abnormal batch. And if we get no normals, then what next? Also we are trying to gather info about the results of transferring an abnormal embryo, so to say. Whether it has resulted in a pregnancy and a healthy birth, or produced opposite results.

I don't understand the thinking that "a test can't create a normal embryo, so why test." The point of testing is so that you don't put your body and mind through the stress of multiple FETs and potentially devastating miscarriages or terminations for medical reasons (TMFR - you will see this acronym on various infertility boards). You also won't waste more months of your rapidly waning fertile years going through months of useless FETs when you could be doing more egg retrievals in hopes of finding a good one. I am not unsympathetic, OP, I did six rounds of IVF over ages 41-42 and the drop-off over that time period in both eggs retrieved and their quality was striking. PGT testing is a really pretty small cost compared to the IVF process as a whole - and NO amount of money can buy back the time you may lose with repeated FETs of untested, ultimately non-viable embryos.

Also one popular argument against testing I hear a lot is people saying they would welcome a child with Down Syndrome anyway, for instance. But what about one with an abnormality that doesn't necessarily prevent a full-term pregnancy but is incompatible with life, e.g. Trisomy 13 or 18? That's another thing to think about. I know there is a lot of talk in some circles these days about how abnormal embryos might somehow correct themselves. I think that's highly unlikely at best and frankly suspect there are some pro-lifers at work in those conversations who are not concerned with the mother's (or father's) mental, physical, and financial stressors at all. At 42, I would absolutely test all your embryos if you're able to get them to blast stage.

Whatever path you take, I wish you good luck. It's a hard road but there really is a lot of wonderful stuff medical science can do these days. Fingers crossed for a healthy baby for you, OP!

I can't thank you enough for this clear explanation! You have helped me understand something about this test/do-not-test thingy which I have had a nagging doubt about, so thank you again
We absolutely do not have any resources or help, physical, financial or emotional support network, to deal with a child with abnormalities and this was our first priority to consider. So we did want to test but again held back since we wanted to know more about the transfers of abnormals.