Mind-blowing article on transferring of PGS-abnormal embryos

[Anonymous]

Anonymous wrote:I have the same question as PP (19:34). My SG doctor acted like this only applied to mosaics (which none of my PGS-tested abnormals were), but I got the impression from several articles that they weren't just talking about mosaics. (I'm too lazy to go look them back up now...)

no. Ravran uses the example of a soccer ball - so you can sample the black field and mistakenly discard.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have the same question as PP (19:34). My SG doctor acted like this only applied to mosaics (which none of my PGS-tested abnormals were), but I got the impression from several articles that they weren't just talking about mosaics. (I'm too lazy to go look them back up now...)

no. Ravran uses the example of a soccer ball - so you can sample the black field and mistakenly discard.

Right, and a mosaic would be some black and some white?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have the same question as PP (19:34). My SG doctor acted like this only applied to mosaics (which none of my PGS-tested abnormals were), but I got the impression from several articles that they weren't just talking about mosaics. (I'm too lazy to go look them back up now...)

no. Ravran uses the example of a soccer ball - so you can sample the black field and mistakenly discard.

Right, and a mosaic would be some black and some white?

Yes according to a braverman's analogy as explained in the article.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It is truly horrifying to think that so many of us could have been discarding embryos that might potentially have become healthy children. I've had 19 test abnormal over the past two years (I am in my 40s) - to think we could have tried with them, and perhaps succeeded with one, is heartbreaking. The downside of cutting-edge technology for sure. But thanks for sharing this article, OP. I am just about to start our final cycle and maybe I'll just tell them to go ahead and implant whatever we get without testing this time.

The problem is they don't know which ones will self correct and which ones will not. About the PGS normals we know that they don't need to self-correct for non-mosaic things.
So unless you're willing to stand a chance of carrying a baby with a severe genetic abnormality, your best bet is still a PGS normal. I have had over a dozen discarded after PGS, and a miscarriage of an abnormal untested embryo and zero kids, so I do feel your pain for the discarded possibilities, but in the end, until the science advances further it's just too risky to transfer PGS abnormals.

How is it risky? NIPT results will tell at 10 weeks if the pregnancy is viable and that is plenty of time for additional testing and termination. It may be more heart-wrenching than not transferring at all, but the potential rewards are infinitely higher than not transferring. For people who cannot get a PGS normal, this is amazing information.

This is so wrong. To have to terminate later is MORE heart wrenching than not to transfer. You must be out of your mind to think that. What is the percentage of the "potential rewards"?

OMG, THIS. If your goal is to have a healthy child and a viable pregnancy than a PGS normal embryo is your best bet, period. The notion that you'd go into a transfer of a PGS abnormal embryo with the mindset that you could "just terminate" if the fetus has an in issue is horrifying. Do you realize how miserable of a choice that is?

[Anonymous]

Anonymous wrote:what i find interesting about the article was that THERE WAS NOT A SINGLE CASE of PGD abnormal embryo that 1) implanted 2) led to miscarriage or abnormal child. the sample sizes were small, sure, but this is still totally amazing.

i am thinking that perhaps those abnormal PGS embryos which are able to self-correct might be stronger than normal embryos.

The sample size IS small and there is no evidence that every PGS abnormal embryo would implant (in fact, the article notes only 6 of 18 women in one case got pregnant with the abnormal embryo) and notes that abnormal embryos don't always self correct.

It's certainly worth exploring further but as a woman who went through multiple rounds of IVF and testing I would not want to take the chance of an abnormal embryo without a good deal more of evidence. Having to terminate because of a defect would be far more painful than having to discard embryos - for me. YMMV.

[Anonymous]

Anonymous wrote:

Anonymous wrote:what i find interesting about the article was that THERE WAS NOT A SINGLE CASE of PGD abnormal embryo that 1) implanted 2) led to miscarriage or abnormal child. the sample sizes were small, sure, but this is still totally amazing.

i am thinking that perhaps those abnormal PGS embryos which are able to self-correct might be stronger than normal embryos.

The sample size IS small and there is no evidence that every PGS abnormal embryo would implant (in fact, the article notes only 6 of 18 women in one case got pregnant with the abnormal embryo) and notes that abnormal embryos don't always self correct.

It's certainly worth exploring further but as a woman who went through multiple rounds of IVF and testing I would not want to take the chance of an abnormal embryo without a good deal more of evidence. Having to terminate because of a defect would be far more painful than having to discard embryos - for me. YMMV.

I also went through several cycles and even if the chances of a healthy child were slim I still would have risked terminating over not having any child at all.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:what i find interesting about the article was that THERE WAS NOT A SINGLE CASE of PGD abnormal embryo that 1) implanted 2) led to miscarriage or abnormal child. the sample sizes were small, sure, but this is still totally amazing.

i am thinking that perhaps those abnormal PGS embryos which are able to self-correct might be stronger than normal embryos.

The sample size IS small and there is no evidence that every PGS abnormal embryo would implant (in fact, the article notes only 6 of 18 women in one case got pregnant with the abnormal embryo) and notes that abnormal embryos don't always self correct.

It's certainly worth exploring further but as a woman who went through multiple rounds of IVF and testing I would not want to take the chance of an abnormal embryo without a good deal more of evidence. Having to terminate because of a defect would be far more painful than having to discard embryos - for me. YMMV.

I also went through several cycles and even if the chances of a healthy child were slim I still would have risked terminating over not having any child at all.

^^ but, yes, would like to see more research around this

[Anonymous]

Anonymous wrote:

Anonymous wrote:what i find interesting about the article was that THERE WAS NOT A SINGLE CASE of PGD abnormal embryo that 1) implanted 2) led to miscarriage or abnormal child. the sample sizes were small, sure, but this is still totally amazing.

i am thinking that perhaps those abnormal PGS embryos which are able to self-correct might be stronger than normal embryos.

The sample size IS small and there is no evidence that every PGS abnormal embryo would implant (in fact, the article notes only 6 of 18 women in one case got pregnant with the abnormal embryo) and notes that abnormal embryos don't always self correct.

It's certainly worth exploring further but as a woman who went through multiple rounds of IVF and testing I would not want to take the chance of an abnormal embryo without a good deal more of evidence. Having to terminate because of a defect would be far more painful than having to discard embryos - for me. YMMV.

there was a lot of embryos that did not implant. What is amazing is that among those that did not a single one results in miscarriage or abnormal child.

This is extremely unlikely to happen even in a small sample size unless the probability of a normal embryo WHICH IMPLANED (a big i if) is extremely low i.e. Comparable to miscarriage of PGS normals

[Anonymous]

Biologist here.

The chances of self-correction are very low.

This research doesn't change anything. It's not even surprising to us researchers.

[Anonymous]

Anonymous wrote:

Biologist here.

The chances of self-correction are very low.

This research doesn't change anything. It's not even surprising to us researchers.

So what if it is low? The downside of transferring them is minimal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Biologist here.

The chances of self-correction are very low.

This research doesn't change anything. It's not even surprising to us researchers.

So what if it is low? The downside of transferring them is minimal.

PP you make no sense unless you think terminating a pregnancy of a non-correcting embryo is a "minimal downside."

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Biologist here.

The chances of self-correction are very low.

This research doesn't change anything. It's not even surprising to us researchers.

So what if it is low? The downside of transferring them is minimal.

PP you make no sense unless you think terminating a pregnancy of a non-correcting embryo is a "minimal downside."

Again there was not a single example of this actually happening.
And yes compared to the infinite GAO of having a child, it is minimal.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Biologist here.

The chances of self-correction are very low.

This research doesn't change anything. It's not even surprising to us researchers.

So what if it is low? The downside of transferring them is minimal.

PP you make no sense unless you think terminating a pregnancy of a non-correcting embryo is a "minimal downside."

Again there was not a single example of this actually happening.
And yes compared to the infinite GAO of having a child, it is minimal.

PP from page 2 who shared that DW worked with Braverman and who is now 25 weeks after transferring two untested embryos frozen on day 1. I do believe this can be a potential last resort for someone who wants desperately to have a child. And we trusted Dr. Braverman when he told us "do not touch those embryos" (i.e., do not send them to be tested). That said, DW terminated a VERY wanted pregnancy in the second trimester due to chromosomal abnormalities. I wouldn't wish this decision and pain on anyone. The pain of going through this versus being childless forever....that's a tough one. And I don't think you can comprehend the pain of that unless you've been through it - nor would you want to.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Biologist here.

The chances of self-correction are very low.

This research doesn't change anything. It's not even surprising to us researchers.

So what if it is low? The downside of transferring them is minimal.

PP you make no sense unless you think terminating a pregnancy of a non-correcting embryo is a "minimal downside."

Again there was not a single example of this actually happening.
And yes compared to the infinite GAO of having a child, it is minimal.

PP from page 2 who shared that DW worked with Braverman and who is now 25 weeks after transferring two untested embryos frozen on day 1. I do believe this can be a potential last resort for someone who wants desperately to have a child. And we trusted Dr. Braverman when he told us "do not touch those embryos" (i.e., do not send them to be tested). That said, DW terminated a VERY wanted pregnancy in the second trimester due to chromosomal abnormalities. I wouldn't wish this decision and pain on anyone. The pain of going through this versus being childless forever....that's a tough one. And I don't think you can comprehend the pain of that unless you've been through it - nor would you want to.

+1. I absolutely agree with characterizing this as a potential last resort. The glib responses to the heartbreaking choice of TMFR underscore why I have never really discussed my own heartbreaking decision. I remain staunchly pro-choice and believe fully that I spared my own child a lifetime of pain. But the PTSD I experienced after this particular loss is something I pray no one ever has to experience.

[Anonymous]

Has anyone here used PGS and then stopped because of articles like this? I've done PGS on 3 batches of blasts and ended up with one normal male each time - all 3 are still in the freezer. I'm on day 6 of stims of the last freeze-all cycle I will ever do and I am debated skipping the testing and just freezing any blasts (if we are lucky enough to get them). I'll be 44 in 6 weeks so this is my final attempt. (If this sounds familiar, I'm the OP of the fairly recent thread on AFC doubling.)

Our son, our only child, has ASD, and while I've love another son the risk of having a 2nd child with ASD is significantly less with a girl (though still a risk). But of the 9 blasts that we know of, 8 were males, of which 3 (plus my son) were normal chromosomally. My most recent cycle was the first time we ever had a female blast, though it was abnormal. I'm been trying to accept that we will likely only have male embryos to transfer, yet I fear I will be so much more anxious during a male pregnancy than a female one. So I am trying to weigh the risks on both sides here. If we do PGS we may not get any normals this cycle (or, if the pattern holds, get 1 normal male), and we could possibly be throwing away a female embryo with the potential to self-correct. On the other hand, if we skip PGS we could end up transferring an embryo with a trisomy and/or that requires a TFMR. There are risks with either choice and assuming that I make it to a live birth the odds are at least 80-90% that the baby would be chromosomally normal (and not have ASD), so I keep telling myself that I will roll the dice, but I have to admit that the thought of a 2nd special needs child of any kind terrifies me. I am leaning towards skipping the PGS testing but I need to talk with my husband and make a decision by Friday. I wish we could just test them and then make our own decision about whether to transfer an abnormal one, but my impression is that Shady Grove won't transfer any abnormals except mosaics, so my choices are either test or don't test. We had 4 blasts make it to freezing last time, and who knows what I'll get this time, but given my age it's not like I'm going to get 10 blasts that it will take 5 FETs to get through. Even if we get lucky I doubt it would take more than 2 FETs to use up all the blasts from this cycle.