Should I do pgt testing for ivf?

[Anonymous]

This is my first ivf cycle. Currently 35. Should I do pgt testing on my embryos? DH and I both did preliminary genetic screenings and neither of us had any noteworthy genetic predispositions. Hesitancy to do pgt testing is due to additional cost, having to wait an extra 2 weeks and consideration that the risk is no different than if I were to get pregnant naturally. Thoughts appreciated!

[Anonymous]

As someone who did 4 retrievals, I actually don't think any of the concerns you raise should stop you from doing it. The added cost, the two weeks, and whether it was worth it, won't matter in the long run when you are raising your child.

What I would weigh is whether you are likely to have a good number of embryos or not. There is always the small chance that PGS testing will result in letting go of an embryo that could have been viable, whether mosaic or a testing error. I had a very hard time getting embryos to days 5/6 for testing so for me there was a real debate about whether it was worth the risk of testing. I still opted to test because it was worth reducing my risk of miscarriage. I found miscarriages emotionally-devastating and they also ate up several months trying to get my hormone levels back to normal to try again, so I chose PGS.

If you are likely to have a decent number of embryos - and especially if you have PCOS which results in a high number of embryos with lower quality - I think it's worth it. If you were over 40 with issues getting embryos to days 5/6 for testing, I'd discuss not testing and doing day 3 transfers with my RE. You could also discuss with your RE only doing PGS if you have say at least 3 embryos to test because really what PGS is best for is narrowing the embryo choice down to greater likelihood of success, hopefully resulting in a shorter path to parenthood.

[Anonymous]

Are you hoping to have multiple children? If so, you may wish to know whether your stored embryos are “good.”

For my first pregnancy, we didn’t test. I spent most of the first trimester anxious about trisomies and miscarriage. My second pregnancy was with a tested embryo and I was much less anxious.

[Anonymous]

If you have a good number of embryos then I would test.

[Anonymous]

Yes. You waste time and risk your life every time you get pregnant (the last D&C my very real options were bleeding out or lose the uterus).

[Anonymous]

Anonymous wrote:As someone who did 4 retrievals, I actually don't think any of the concerns you raise should stop you from doing it. The added cost, the two weeks, and whether it was worth it, won't matter in the long run when you are raising your child.

What I would weigh is whether you are likely to have a good number of embryos or not. There is always the small chance that PGS testing will result in letting go of an embryo that could have been viable, whether mosaic or a testing error. I had a very hard time getting embryos to days 5/6 for testing so for me there was a real debate about whether it was worth the risk of testing. I still opted to test because it was worth reducing my risk of miscarriage. I found miscarriages emotionally-devastating and they also ate up several months trying to get my hormone levels back to normal to try again, so I chose PGS.

If you are likely to have a decent number of embryos - and especially if you have PCOS which results in a high number of embryos with lower quality - I think it's worth it. If you were over 40 with issues getting embryos to days 5/6 for testing, I'd discuss not testing and doing day 3 transfers with my RE. You could also discuss with your RE only doing PGS if you have say at least 3 embryos to test because really what PGS is best for is narrowing the embryo choice down to greater likelihood of success, hopefully resulting in a shorter path to parenthood.

Terrible advice, though. Most of those day 3 are likely abnormal at 40+.

[Anonymous]

I didn't but only got one embryo that I am unable to transfer at this time due to another condition discovered during the IVF retrieval process. It would have been included in our package, but we only got one and I am willing to see what happened as that is how it would have been naturally.

If you had genetic issues or a history of loss, would feel differently, but if you are infertile definitely wouldn't unless I got six plus embryo at blastocyst, assuming you are not just trying for one child.

[Anonymous]

Yes, you should

[Anonymous]

I would suggest making sure you know how the clinic uses the results before testing. We learned (in advance) that ours would not transfer embryos with genetic issues that did not decrease life expectancy, but that they considered lead to a lower quality of life. We did not test for that reason and the delay factor.

[Anonymous]

I did genetic testing at 35 and have mixed feelings about it. I had one miscarriage and one failed transfer of euploid embryos. I had success with my one remaining euploid embryo. At the time it felt sort of like a waste of money to test, but it does rule stuff out. I think my RE was more willing to try different protocols because they knew that abnormal genes were not the cause of my failed transfers, which is usually the default assumption. One additional thing to keep in mind if you are paying out of pocket is that genetic testing is usually cheaper than an FET.

[Anonymous]

Anonymous wrote:I would suggest making sure you know how the clinic uses the results before testing. We learned (in advance) that ours would not transfer embryos with genetic issues that did not decrease life expectancy, but that they considered lead to a lower quality of life. We did not test for that reason and the delay factor.

+1

[Anonymous]

Your age and the number of embryos you get per cycle is the key. If you’re over 35 and only getting 1-2 per cycle, you need to test. You can’t afford the 3-6 months wasted when you miscarry a genetically abnormal embryo.

[Anonymous]

I'd absolutely test. Without testing each cycle is a black box and if not successful you'll have far less information on why. It's also possible to have a lot of eggs/embryos and have few viable ones, or you could only have a few embryos and most are viable. Unless you test you have no idea. This is especially important if you would like to have more than one child.

[Anonymous]

Pro
Reduces miscarriage
Can be cost effective depending on the package and FET costs
Can help rule out other causes of infertility
Can spare you from a pregnancy termination, such as for Down Syndrome

Con
The biopsy process cannot be good for the embryo
Can get ambiguous results, like mosaic
Results in lower live birth rate, presumably due to false positives
Can't actually increase chance of a take home baby, it does not make a bad embryo good, only good embryos are take home babies