Poorly graded embryos, any hope for euploid?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm glad your clinic is at least considering CC graded embryos. For my last cycle I had 3 blasts, AA, BA, and CC. My clinic discarded the CC automatically and told me the CC won't even make it through the freeze/thaw so their protocol is to discard CC blasts. I've always heard grading is just a beauty contest, a lot of variability depending on the specific embryologist, so it sucks my clinic cares so much about the grading.

FWIW - My BA blast ended up being euploid, AA aneuploid. Throughout all my cycles, I've also had a BB that was aneuploid, AC that was euploid. I just ended my cycle with another euploid blast, this time it was graded AB.

The clinic gets more money the more embryos they trash, also hold hands a little less with miscarriages and D+Cs.

I didn't know this about clinics before hand, but some of them do trash ugly embryos without asking. Others will not transfer a mosaic.

PGS testing actually lowers take-home baby rate. Think about it, how could it raise the take-home baby rate? It's not like it's fixing bad embryos

I agree with this. After many, may rounds of IVF I realized that the attrition rate was too high. They discard embryos that don’t look beautiful because there have been studies in the past that highly graded embryos tend to stick. I think the clinics are closely monitoring their stats and if only transferring beautiful embryos marginally improves their stats they will go with that- to the detriment of us who just want every chance possible

if this is a concern go to a clinic that keeps mosaics/ccs/7s... mine does.. but they obviously don't encourage transfering an aneuploid. mine are still fully on ice- they don't discard them but wouldn't ethically recommend transferring them. and maybe i'm overly optimistic in life (far from the truth) but i think someone goes into fertility care to help get people pregnant, not to destroy embryos/make more money. i'm a psychologist and always hate when patients imply i want them to have more issues so i can get paid more-- obviously would rather all mental illness be alleviated and i would be thrilled to find another career

[Anonymous]

Anonymous wrote:Why aren't clinics just doing full genome sequencing? Wouldn’t it be nice to know an embryo’s risk for cancer, low iq, mental illness, etc?

Full genome sequencing is very expensive for embryos. The DNA samples collected from PGT only include a handful of cells (2-5 range) this DNA needs to be amplified many times then sequenced 30-50x to ensure an acceptable level of accuracy. The only company that offers whole genome sequencing for Embryos charges $2,500 per embryo. If you have ten embryos that is $25k just for DNA sequencing. This genetic testing can effectively double the cost of an IVF cycle .

[Anonymous]

Any updates, OP?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm glad your clinic is at least considering CC graded embryos. For my last cycle I had 3 blasts, AA, BA, and CC. My clinic discarded the CC automatically and told me the CC won't even make it through the freeze/thaw so their protocol is to discard CC blasts. I've always heard grading is just a beauty contest, a lot of variability depending on the specific embryologist, so it sucks my clinic cares so much about the grading.

FWIW - My BA blast ended up being euploid, AA aneuploid. Throughout all my cycles, I've also had a BB that was aneuploid, AC that was euploid. I just ended my cycle with another euploid blast, this time it was graded AB.

The clinic gets more money the more embryos they trash, also hold hands a little less with miscarriages and D+Cs.

I didn't know this about clinics before hand, but some of them do trash ugly embryos without asking. Others will not transfer a mosaic.

PGS testing actually lowers take-home baby rate. Think about it, how could it raise the take-home baby rate? It's not like it's fixing bad embryos

I agree with this. After many, may rounds of IVF I realized that the attrition rate was too high. They discard embryos that don’t look beautiful because there have been studies in the past that highly graded embryos tend to stick. I think the clinics are closely monitoring their stats and if only transferring beautiful embryos marginally improves their stats they will go with that- to the detriment of us who just want every chance possible

if this is a concern go to a clinic that keeps mosaics/ccs/7s... mine does.. but they obviously don't encourage transfering an aneuploid. mine are still fully on ice- they don't discard them but wouldn't ethically recommend transferring them. and maybe i'm overly optimistic in life (far from the truth) but i think someone goes into fertility care to help get people pregnant, not to destroy embryos/make more money. i'm a psychologist and always hate when patients imply i want them to have more issues so i can get paid more-- obviously would rather all mental illness be alleviated and i would be thrilled to find another career

I'm sorry to tell you but reproductive immunology attracts the money grubbers because it is mostly cash and it is elective.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm glad your clinic is at least considering CC graded embryos. For my last cycle I had 3 blasts, AA, BA, and CC. My clinic discarded the CC automatically and told me the CC won't even make it through the freeze/thaw so their protocol is to discard CC blasts. I've always heard grading is just a beauty contest, a lot of variability depending on the specific embryologist, so it sucks my clinic cares so much about the grading.

FWIW - My BA blast ended up being euploid, AA aneuploid. Throughout all my cycles, I've also had a BB that was aneuploid, AC that was euploid. I just ended my cycle with another euploid blast, this time it was graded AB.

The clinic gets more money the more embryos they trash, also hold hands a little less with miscarriages and D+Cs.

I didn't know this about clinics before hand, but some of them do trash ugly embryos without asking. Others will not transfer a mosaic.

PGS testing actually lowers take-home baby rate. Think about it, how could it raise the take-home baby rate? It's not like it's fixing bad embryos

I agree with this. After many, may rounds of IVF I realized that the attrition rate was too high. They discard embryos that don’t look beautiful because there have been studies in the past that highly graded embryos tend to stick. I think the clinics are closely monitoring their stats and if only transferring beautiful embryos marginally improves their stats they will go with that- to the detriment of us who just want every chance possible

if this is a concern go to a clinic that keeps mosaics/ccs/7s... mine does.. but they obviously don't encourage transfering an aneuploid. mine are still fully on ice- they don't discard them but wouldn't ethically recommend transferring them. and maybe i'm overly optimistic in life (far from the truth) but i think someone goes into fertility care to help get people pregnant, not to destroy embryos/make more money. i'm a psychologist and always hate when patients imply i want them to have more issues so i can get paid more-- obviously would rather all mental illness be alleviated and i would be thrilled to find another career

I'm sorry to tell you but reproductive immunology attracts the money grubbers because it is mostly cash and it is elective.

Who mentioned reproductive immunology?

And you may be unaware but md and soon dc mandate fertility coverage- I know 4 people that did ivf this year and all of them were through insurance through employer

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm glad your clinic is at least considering CC graded embryos. For my last cycle I had 3 blasts, AA, BA, and CC. My clinic discarded the CC automatically and told me the CC won't even make it through the freeze/thaw so their protocol is to discard CC blasts. I've always heard grading is just a beauty contest, a lot of variability depending on the specific embryologist, so it sucks my clinic cares so much about the grading.

FWIW - My BA blast ended up being euploid, AA aneuploid. Throughout all my cycles, I've also had a BB that was aneuploid, AC that was euploid. I just ended my cycle with another euploid blast, this time it was graded AB.

The clinic gets more money the more embryos they trash, also hold hands a little less with miscarriages and D+Cs.

I didn't know this about clinics before hand, but some of them do trash ugly embryos without asking. Others will not transfer a mosaic.

PGS testing actually lowers take-home baby rate. Think about it, how could it raise the take-home baby rate? It's not like it's fixing bad embryos

I agree with this. After many, may rounds of IVF I realized that the attrition rate was too high. They discard embryos that don’t look beautiful because there have been studies in the past that highly graded embryos tend to stick. I think the clinics are closely monitoring their stats and if only transferring beautiful embryos marginally improves their stats they will go with that- to the detriment of us who just want every chance possible

if this is a concern go to a clinic that keeps mosaics/ccs/7s... mine does.. but they obviously don't encourage transfering an aneuploid. mine are still fully on ice- they don't discard them but wouldn't ethically recommend transferring them. and maybe i'm overly optimistic in life (far from the truth) but i think someone goes into fertility care to help get people pregnant, not to destroy embryos/make more money. i'm a psychologist and always hate when patients imply i want them to have more issues so i can get paid more-- obviously would rather all mental illness be alleviated and i would be thrilled to find another career

I'm sorry to tell you but reproductive immunology attracts the money grubbers because it is mostly cash and it is elective.

Who mentioned reproductive immunology?

And you may be unaware but md and soon dc mandate fertility coverage- I know 4 people that did ivf this year and all of them were through insurance through employer

sorry reproductive endocrinology

i too have coverage, it's only for one cycle though, does your policy have a limit? Most do

The vast majority of IVF is cash payment

[Anonymous]

Anonymous wrote:

Anonymous wrote:Why aren't clinics just doing full genome sequencing? Wouldn’t it be nice to know an embryo’s risk for cancer, low iq, mental illness, etc?

Full genome sequencing is very expensive for embryos. The DNA samples collected from PGT only include a handful of cells (2-5 range) this DNA needs to be amplified many times then sequenced 30-50x to ensure an acceptable level of accuracy. The only company that offers whole genome sequencing for Embryos charges $2,500 per embryo. If you have ten embryos that is $25k just for DNA sequencing. This genetic testing can effectively double the cost of an IVF cycle .

Right, but the return on the investment could be 100x. It’s a lot cheaper than college. If you have a healthy baby with low risk for developmental, cognitive, mental, and physical disorders you can save you and the baby hundreds of thousands of dollars over a lifetime. I don’t understand why this is not done as standard practice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Why aren't clinics just doing full genome sequencing? Wouldn’t it be nice to know an embryo’s risk for cancer, low iq, mental illness, etc?

Full genome sequencing is very expensive for embryos. The DNA samples collected from PGT only include a handful of cells (2-5 range) this DNA needs to be amplified many times then sequenced 30-50x to ensure an acceptable level of accuracy. The only company that offers whole genome sequencing for Embryos charges $2,500 per embryo. If you have ten embryos that is $25k just for DNA sequencing. This genetic testing can effectively double the cost of an IVF cycle .

Right, but the return on the investment could be 100x. It’s a lot cheaper than college. If you have a healthy baby with low risk for developmental, cognitive, mental, and physical disorders you can save you and the baby hundreds of thousands of dollars over a lifetime. I don’t understand why this is not done as standard practice.

Most genetic traits are polygenic and the genetic correlation between traits is generally weak. The genes conferring these traits are inherited randomly with 50% from each parent. It is unlikely that you will get an embryo that has a genetic royal flush, with a high predicted IQ, low risk for all major mental disorders, tall, and low risk for most diseases. The major limiting factor for the efficacy of polygenic selection is the number of embryos. With the best (currently available models), the average expected gain for embryo selection based on predicted IQ score is 4-6 points if you pick the highest scoring out of 10 embryos. If you have 50 embryos and pick the best scoring one, the average expected gain is 7-9 IQ points. Unfortunately, the embryo that has the highest predicted IQ score is not likely to be the one that also has the lowest risk for heart disease and Alzheimers. Unless you have 100's of embryos or even thousands, it is unlikely that you will get an embryo that has a significantly higher predicted IQ than the parents which is also low risk for most major diseases. In my situation, I had less than 10 embryos and the range in predicted IQ between the highest and lowest scoring embryo was only 5 points.