Preimplantation Genetic Screening - Success/Views?

[Anonymous]

Has anyone gone through pre-implantation genetic screening with IVF and have any views on it? Are there certain facilities that are better or more advanced in this area? After one successful pregnancy, I have had three miscarriages in a row and am wondering whether this should be an option for us. We have done IUI for the last two pregnancies (each ended about the 12th week), but have never tried IVF.

[Anonymous]

I'm also interested in this area. I think Shady Grove does PGD. Anyone?

[Anonymous]

I think the new thing is cgh where they test for all chromosomes
Pgd only tests for some

[Anonymous]

Op do you know your losses are chromosomal?

[Anonymous]

We did IVF 9 times at Shady Grove and did PGD on most of those for a chromosome abnormality which causes us to have a 50% chance of Trisomy 13 or 14 baby. I have mixed feelings about the process.

My first child was conceived at 4 IVF PGD cycles. I think PGD is good at giving you information about what is going on with your embryos but the information is limited based on what you are testing for. We tested for my husband's chromosome issue along with chromosomes 13, 18, 21 and the "sex" chromosome. So there are still a lot of chromosomes which they aren't testing. When we were cycling 3 years ago - Dr. Kearns (the head of the PGD lab) talked about doing something to CGH where they can test all of the chromosomes but I'm not sure if SGF is going that yet or not.

We did another 5 IVF cycles to conceive a sibling - we did PGD on 4 of them. We kept miscarrying beautiful 5 Day Blasts that were PGD normal which was devasting. So on our last cycle we decided to not do PGD and just put back our 3 remaining embryos on Day 3. That cycle resulted in my twins.

I think PGD has it's strengths and weaknesses. I think the process itself is hard on the embryos (removing the cell for biopsy) which is why we decided to not do PGD on our last cycle. I believe that SGF is now doing the biopsies later in the cycle (so on Day 4 or 5 rather than Day 3) hoping that the embryo is stronger and can sustain the biopsy easier. When we were doing PGD - it was 95% accurate so we did a CVS with both pregnancies to confirm but that might not be an issue for you. I still had 3 miscarriages even after doing IVF PGD so it's not a silver bullet solution to conceiving a child. I naively thought that if we had PGD normal embryos left on Day 5 - we were a "shoe in" for pregnancy. And after we got a positive pregnancy test - I thought we had a home run - only to miscarry again.

If you do it - I would say go into it knowing that PGD can provide you some answers but like anything - it has its limitations. The IVF process itself is very hard - I never did IUI so I don't have anything to compare it to. But I found IVF emotionally and physically draining. And honestly now I'm scared to death of what I've done to my body after juicing up on hormones for so many cycles. I keep having cysts develop in my breasts since having my kids and I can't wonder but worry if too many hormones for too many cycles is going to have a negative affect on my health. Don't get my wrong - I'm thankful for my 3 kids but I'm not sure if would jump as quickly onto the IVF PGD bandwagon if I had been able to conceive on my own (we never had a "natural" pregnancy) because of the emotional, financial and physical toll it took on us.

[Anonymous]

Anonymous wrote:We did IVF 9 times at Shady Grove and did PGD on most of those for a chromosome abnormality which causes us to have a 50% chance of Trisomy 13 or 14 baby. I have mixed feelings about the process.

My first child was conceived at 4 IVF PGD cycles. I think PGD is good at giving you information about what is going on with your embryos but the information is limited based on what you are testing for. We tested for my husband's chromosome issue along with chromosomes 13, 18, 21 and the "sex" chromosome. So there are still a lot of chromosomes which they aren't testing. When we were cycling 3 years ago - Dr. Kearns (the head of the PGD lab) talked about doing something to CGH where they can test all of the chromosomes but I'm not sure if SGF is going that yet or not.

We did another 5 IVF cycles to conceive a sibling - we did PGD on 4 of them. We kept miscarrying beautiful 5 Day Blasts that were PGD normal which was devasting. So on our last cycle we decided to not do PGD and just put back our 3 remaining embryos on Day 3. That cycle resulted in my twins.

I think PGD has it's strengths and weaknesses. I think the process itself is hard on the embryos (removing the cell for biopsy) which is why we decided to not do PGD on our last cycle. I believe that SGF is now doing the biopsies later in the cycle (so on Day 4 or 5 rather than Day 3) hoping that the embryo is stronger and can sustain the biopsy easier. When we were doing PGD - it was 95% accurate so we did a CVS with both pregnancies to confirm but that might not be an issue for you. I still had 3 miscarriages even after doing IVF PGD so it's not a silver bullet solution to conceiving a child. I naively thought that if we had PGD normal embryos left on Day 5 - we were a "shoe in" for pregnancy. And after we got a positive pregnancy test - I thought we had a home run - only to miscarry again.

If you do it - I would say go into it knowing that PGD can provide you some answers but like anything - it has its limitations. The IVF process itself is very hard - I never did IUI so I don't have anything to compare it to. But I found IVF emotionally and physically draining. And honestly now I'm scared to death of what I've done to my body after juicing up on hormones for so many cycles. I keep having cysts develop in my breasts since having my kids and I can't wonder but worry if too many hormones for too many cycles is going to have a negative affect on my health. Don't get my wrong - I'm thankful for my 3 kids but I'm not sure if would jump as quickly onto the IVF PGD bandwagon if I had been able to conceive on my own (we never had a "natural" pregnancy) because of the emotional, financial and physical toll it took on us.

Wow! What a road you've travelled -- thanks for sharing your experience. All the best to you and your family!

[Anonymous]

OP here - thanks so much for the feedback. We are getting the remains from today's d&c tested, but didn't on the others. It does seem to be such a tricky area (and dc area may not have all the latest technologies), so thank you so much for sharing your experiences.

[Anonymous]

I'm the 20:09 poster again (and sorry for all the typos in my previous post - yikes). I just wanted to ask - did your doctor do a Karotype test on you and your husband yet? It's a simple blood test which maps at your chromosomes. It's highly unlikely you have what my husband has (called a balanced translocation) but it causes no problems other than fertility - primarily miscarriages. SGF does the test as part of its baseline testing but not all clinics do.

I don't have any personal experience with CGH - that was developed after we were doing PGD at SGF. But one of the issues with CGH I believe is that you have to freeze the embryo b/c it takes a bit longer to test all the chromosomes and then you go back and do a frozen transfer. And FET usually have less sucess than fresh. One good thing about SGF is they have a PGD shared risk program which is why we went with that clinic - I couldn't find another clinic which offered shared risk for PGD candidates. Look at CCRM or SIRM for information about CGH.

I hope the results from your D&C might provide some insight into what's going on. I'm so sorry for your losses - it's a very tough road to be on.

[Anonymous]

Op so sorry to hear what you are going trough. I am on the same boat, 3 mc in a row (first one exactly s year ago) after a perfect pg 2.5 years ago. I am 30 so for now I think I will play my odds and keep trying to get pg on my own before we move on to ivf with Pgd.
Best of luck to you.

[Anonymous]

Personally, I don't think PGD is worth the $$ in terms of the reliability of information you get. There are just too many issues it doesn't catch. If you really want to go the genetic testing route, I'd go to SIRM or CCRM and do CGH instead. With that said, keep in mind that genetic testing doesn't improve the likelihood of getting a normal embryo--it only identifies them.

I also think it's important to rule out other issues first. For example, immune problems can cause secondary infertility (via repeated miscarriage or implantation failure). Unfortunately, it's a controversial area and there aren't many doctors here in DC who will do the tests. To my knowledge, Dr. Abbasi at Columbia Fertility is the only one. If you're willing to travel, SIRM also tests for this.

[Anonymous]

Sirm will test you for nk cells and dq alpha without traveling
Call them for a free phone consultation

[Anonymous]

Don't quote me, but I think CFA will do CHG. After our third lost we did genetic testing of both my husband and myself and were going to do CHG with CFA if either one of us came back with an issue. Neither one of us did, so I don't have experience with the actual process.

[Anonymous]

15:08 - if you don't mind me asking, did you have success after the third loss (at CFA or otherwise)?

[Anonymous]

15:08 -- I think you might be thinking of something different. Pre-conception genetic testing for the parents (karotyping?) is not the same as genetic testing on embryos, which occurs between retrieval and transfer. CFA probably does karotyping, but the last I spoke to them they were not doing CGH--only PGD.

[Anonymous]

15:08 here - Nope I am not thinking of something different. Our most recent loss was karyotyped and it came back as trisomy 17. Dr. Sacks then karyotyped both my husband and I to see if there was something that would predispose us to trisomy 17. If either of us test positive, during our next IVF we would biopsy our embryos and send them off for CHG. PGD would have been worthless because they don't test chormosome 17. The reason I said don't quote me is that I don't know if CHG is a standard for them or if they only do it in cases where they are looking for something specific.

15:49 - We had sucess between loss #1 and #2, but nothing since.