Does Your Clinic Do PBB or PGD Before Implanting?

[Anonymous]

I agree with the pp. This is just not standard practice these days, as the costs are high (both in terms of money and possible damage to the embryos) and I don't think it's really proven to help, in general. I think at your age, with the number of embryos you produced, that it doesn't make sense for you to do it, but of course, feel free to get multiple opinions from various REs. My sense is that it's really the luck of the draw. I hope this one works out for you, or that you are successful on your next try.

[Anonymous]

Anonymous wrote:I think at your age, with the number of embryos you produced, that it doesn't make sense for you to do it

This is the part I'm not understanding though. Even if merely produce 6 embies, why is it worth it to do PGD. Why would any RE assume it's better for me to have children with chromosomal abnormalities than none at all? If all the embies were found abnormal, I would not want any implanted at all. I'd want to try for another cycle and keep trying hopefully until they find normal embies.

[Anonymous]

Sorry, I mistyped. I meant to say, "Even if I produce 6 embies, why is it not worth it for me to have PGD done."

[Anonymous]

We have undergone IVF PGD 7 times with Shady Grove out of a possible 9 total IVF cycles. It took us 4 attempts to conceive our first child and another 5 attempts to conceive my current pregnancy. My husband is a carrier for a chromsome abnormality which carries a higher risk of creating children with Trisomy 13 or 14 which is why we went the PGD route. PGD is limited as to how many chromosome abnormalities it can test for - I believe it's Trisomy 13, 18, 21 and the "sex" chromsome" along with testing for your particular chromsome abnormality - in our case it was called a translocation - which leaves a lot of room for potential problems with the other chromosomes. Even with PGD - I still miscarried 3 times with IVF PGD and my RE always said it's because PGD has it's limitations. Because we kept miscarrying even with beautiful "PGD normal" embryos - we decided to forgo PGD on our last cycle which thankfully still produced a healthy pregnancy. So while PGD is good for providing some insight into what's going on with your embryos - it also has it's limitations.

The more embryos you have to start with - the more likely you are to be successful with PGD - it's just a numbers game. PGD is expensive - for us it was an additional $3,200 per cycle just for the testing but this will vary based on what you are testing for. They won't just throw it in for the heck of it - you have to know up front you are going to do this because they will only start a certain number of PGD patients at the same time so the PGD lab doesn't get overwhelmed. We did PGD testing on as little as 1 embryo (because that's all we had left on Day 3) or as many as 10 so they will do the testing regardless of how few embryos you have - you'll just improve your odds if you have more. It's a lot to swallow finanically to spend $3,200 to test just one embryo when you could just roll the dice and put it back and see how things turn out and ultimately do a CVS or amnio.

I really hope your pregnancy works out for you - it's such a tough waiting game. But if you have to consider options please keep in mind that PGD isn't a "cure all" - I still miscarried after using it 3 times and I know many girls who made it to their CVS and then still found out their baby had chromosome abnormalities. Until they can test all the chromosomes - you still run the risk of chromsome abnormalities.

[Anonymous]

I'm not the OP but PP that's a very helpful, informed reality check. And you went through a ton of IVFs -- I'm not sure I have that in me physically, emotionally and especially financially so I admire your persevernce and am glad to know you ended up with healthy pregnancies/babies. thanks.

[Anonymous]

Anonymous wrote:We have undergone IVF PGD 7 times with Shady Grove out of a possible 9 total IVF cycles. It took us 4 attempts to conceive our first child and another 5 attempts to conceive my current pregnancy. My husband is a carrier for a chromsome abnormality which carries a higher risk of creating children with Trisomy 13 or 14 which is why we went the PGD route. PGD is limited as to how many chromosome abnormalities it can test for - I believe it's Trisomy 13, 18, 21 and the "sex" chromsome" along with testing for your particular chromsome abnormality - in our case it was called a translocation - which leaves a lot of room for potential problems with the other chromosomes. Even with PGD - I still miscarried 3 times with IVF PGD and my RE always said it's because PGD has it's limitations. Because we kept miscarrying even with beautiful "PGD normal" embryos - we decided to forgo PGD on our last cycle which thankfully still produced a healthy pregnancy. So while PGD is good for providing some insight into what's going on with your embryos - it also has it's limitations.

The more embryos you have to start with - the more likely you are to be successful with PGD - it's just a numbers game. PGD is expensive - for us it was an additional $3,200 per cycle just for the testing but this will vary based on what you are testing for. They won't just throw it in for the heck of it - you have to know up front you are going to do this because they will only start a certain number of PGD patients at the same time so the PGD lab doesn't get overwhelmed. We did PGD testing on as little as 1 embryo (because that's all we had left on Day 3) or as many as 10 so they will do the testing regardless of how few embryos you have - you'll just improve your odds if you have more. It's a lot to swallow finanically to spend $3,200 to test just one embryo when you could just roll the dice and put it back and see how things turn out and ultimately do a CVS or amnio.

I really hope your pregnancy works out for you - it's such a tough waiting game. But if you have to consider options please keep in mind that PGD isn't a "cure all" - I still miscarried after using it 3 times and I know many girls who made it to their CVS and then still found out their baby had chromosome abnormalities. Until they can test all the chromosomes - you still run the risk of chromsome abnormalities.

PP, I am sure I misread as I'm rushing off to go make dinner now. But was PGD $3200 for you per cycle or $3200 per embie testing? I think to avoid repeated miscarriages (in the interest of time and heartache) I would pay the $3200 per cycle to do PGD. I can not, however, afford $3200 if it was a per embie cost!
I've been through 3 IVF's now. I still have it in me to do a couple more in our quest to have a second child. THe previous IVF's were very manageable for me. There is of course tremendous heartache associated with each failed attempt but at 42 I expect a few failed cycles. I want to give DS a sibling so badly so thats what is motivating me to keep trying...for now. But of course I want a healthy child if at all possible.

[Anonymous]

It cost us $3,200 per cycle to do PGD not per embryo (so whether they test one embryo or 10 - it's the same price) but the cost will totally vary based on what exactly they are testing your embryos for. For instance, I think the basic package where they just do aneuplody testing where they look for the trisomies and abnormalities with the sex chromosome is the cheapest and when we signed our contract several years ago - that was running between $2K-$2,500.

I do think Shady Grove has a competent PGD Lab (I think they're actually separate entities - the lab is owned by Lab Corp now or something) especially because my first child was conceived through it. I just think it's important to keep a realistic outlook that while PGD can be helpful to those with chromosome abnormalities by selecting healthy embryos pr beneficial in providing information to those with multiple failed cycles/miscarriages - it's not a guarantee that you'll have a healthy pregnancy. I think I was very naive initially believing that if I had beautiful 5 day PGD normal blasts - we were golden and we learned multiple times that nothing in IVF is a given - it's totally rolling the dice even with the information PGD provides. Our RE started to wonder as we continued to have negative results with PGD normal embryos if maybe the biopsy process was too hard on them which is why on our last cycle - we just put the remaining 3 back on Day 3 with no PGD and I'm pregnant with twins - and they didn't even look good on Day 3 - we had a 8, 6 and 5 cell all with fragmentation.

[Anonymous]

PP, this is the OP again.

Thanks for offering your story. It helps me as we are now trying to decide which clinic to go for and as we go for consultations.

How are you doing now btw? I hope the twins are doing well.

[Anonymous]

No problem at all - I'm so sorry you're struggling with infertility as well. I think it's a good idea to go for second opinions if that's something you're interested in. You definitely need to be your own advocate and make sure the doctors are doing all that is possible to help you succeed especially so you feel confident in your treatment.

We also had 2 second opinions after our 4th (8th overall) failed IVF cycles with 2 clinics in NY and NJ that specialize in our particular issue - we just sent our records up and did the consults over the phone. (And we were very upfront with out SGF doctor that we were seeking other opinions.) Both of them agreed that SGF was doing everything possible to help us and didn't have any suggestions about how to change my protocol, etc. to achieve better results. That being said - they didn't hesitate to try and get us to switch to their clinic so just be cautious when getting second opinions because (sadly) this is a business for the doctors as much as you'd like to think they're doing it to help you - they also want to attract patients. I honestly think a lot of IVF is more of an art and a science and doctors do the best they can do and at the end of the day - they just don't know no matter what stats, etc. they provide. We never had a clear answer as to why our cycles weren't working which can be extremely frustrating when I wanted to be able to point the finger at something, fix it and then try again.

Hang in there - I'm sure it will work for you - I always felt it was a matter of "when" rather than "if" and the more times we tried - the more they doctors learned about our particular case so we could fine tune my meds, etc. It's just hard emotionally, financially and physically to endure it. We took 8 months off before doing our last cycle and I honestly think that long break helped us regroup and dive back in one more time with a clear head. Best of luck to you.

[Anonymous]

PP, do you mind me asking how old you are?

I'd try numerous times if I had the time. At 42, I feel I'm running out of time really fast.

I, too, feel that it was only a matter of 'when' and not 'if'. But because of the time constraints, I am wondering if the situation has now turned to 'if' for me.

[Anonymous]

I'm in my mid 30s however my body doesn't respond well at all to the highest dosage of medication. I have tried almost every drug protocol out there and we usually had the same results - about 7-8 mature eggs and maybe 3 embryos left on Day 3. So while I might be on the younger side of fertility treatments - my body didn't respond like a 30 something year old - I have borderline high FSH so we usually had problems with my eggs in addition to my husband's chromosome issue.

It is a good sign that you became pregnant with your cycle albeit it would have been ideal if they cycle actually worked - believe me I've been there many times and it's hard to say anything good came out of a failed cycle. But it does show that your body can get pregnant. If you otherwise had a good cycle - decent number of eggs retrieved, at least 50% fertilize it might just be that you need to try again. But if you felt anything with your cycle didn't go as it should whether it's the care you received, decisions the doctors made, etc. - I would definitely bring them up with your RE if you decide to do a follow up consult with SGF. I always asked my RE what we could do differently to try and achieve different results - you want to feel confident in the care you're receiving to help maintain your positive outlook. There are plenty of other doctors you can consult with in the DC area or other major cities - just do your research and be cautious about those guaranteeing you anything because I seriously think some REs promise anything to get you to cycle with them. As an aside - if you decided to a second opinion - request your records from SGF soon or just see if you RN can xerox them for you. They have an outside firm that handles this for them and it seemed to take a long time to get them from SGF so don't think you can get them in just a matter of days unless your RN is nice and will just fax them to you - I was naive in thinking it would be an easy process.

Hang in there and I wish you all the best.

[Anonymous]

Thanks so much PP for all the helpful suggestions.

I got my SGF records and have sent them to one new clinic, CCRM. I dread the time and expense to fly over there though.

I'm also considering Cornell as it's closer.

Good luck with you too!

[Anonymous]

I've heard fantastic things about both clinics - you'll be in great hands. One last thing - if you need a good online support community if you don't have one already - check out http://www.babystepsforum.com/ It's an offshoot group that used to be on Resolve - I've been a member for 3 years and couldn't have survived without them. I'm pretty sure membership is open again - it was closed a while ago but I don't think that's an issue now. Very supportive group of women going through all different types of IF treatments.

[Anonymous]

I will be sure to check it out.

Thanks again soo much.

[Anonymous]

I am so sorry to hear about your situation and possibly miscarriage. I had three in a row, and know how crazy-painful it can be.

I am about to do IVF with PGD at SG. This is medically indicated for me because of my repeat miscarrages. All my tests were normal at SG, so the miscarriages are probably due to my age (40). At my age, about half of my eggs are damaged, so the PGD will test them to select the healthiest ones and decrease my chance of miscarriage.

Note that insurance does not usually cover PDG (even if your IVF is covered). So, for us, PGD will cost an extra $4500 ($1500 for the PGD biopsy at SG, and $2000 for the genetic diagnosis at the lab).

I wanted to mention that I spoke with the geneticist at SG in Rockville about PGD last week. He told me that new PGD technology will be available within the next two months, likely. Actually, he said they are ready to offer it now, but they need to sort our some legal issues first with their lab's parent organization, Labcorps (which should take about 2 months). The new technology increases the chance of success of IVF with PGD because they do a genetic diagnosis of all 23 chromosomes in an embryo, rather than looking only at 10 chromosomes, as they do now. I was told that this procedure would only be slightly more expensive ($500-$1000 more) than the current 10-chromosome method.

Keeping you in my thoughts for a positive outcome!