Mind-blowing article on transferring of PGS-abnormal embryos

[Anonymous]

Anonymous wrote:

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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.

glib responses <<< glib destruction of potentially viable embryos

[Anonymous]

Anonymous wrote: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.

I would freeze any blasts I get. You have already tested several times. It's time to try something different

[Anonymous]

Anonymous wrote: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.

I would still test if I were you. If you try with untested embryos and end up miscarrying or terminating, you end up really burning up tons of time. You need to wait afterward until your body is ready again and the whole process could take up to half a year. At 44 I wouldn't want to waste that kind of time. And with several blasts to try, you likely wouldn't put them all in at once, so you might need a couple of attempts. Also, if cost is a factor, FETs are cheaper than ERs, but it still adds up. Even with a girl, you could end up with any number of other special health care needs, even from a PGS normal embryo. I totally understand your logic and your fear, though. Good luck with a tough decision.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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.

I would freeze any blasts I get. You have already tested several times. It's time to try something different

I would transfer 2-3 on day 2-3 and then freeze any others that become blasts. You still have three "healthy" blasts on ice for future FETs.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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.

I would still test if I were you. If you try with untested embryos and end up miscarrying or terminating, you end up really burning up tons of time. You need to wait afterward until your body is ready again and the whole process could take up to half a year. At 44 I wouldn't want to waste that kind of time. And with several blasts to try, you likely wouldn't put them all in at once, so you might need a couple of attempts. Also, if cost is a factor, FETs are cheaper than ERs, but it still adds up. Even with a girl, you could end up with any number of other special health care needs, even from a PGS normal embryo. I totally understand your logic and your fear, though. Good luck with a tough decision.

There are no guarantees. I transferred a PGS normal "perfect" hatching blast (FET) and it miscarried at 8 weeks, with another 3 months waiting for HCG to go down and another month wasted on saline sonos and HSG which found debris that needed a hysteroscopy to flush out. All in all I wasted 7 months on the whole process.... and now back to square one.

[Anonymous]

There are a lot of responses now...it's clear that many folks *would* have preferred the chance to transfer some abnormal or perhaps day 3 untested embryos rather than wait for a day 5 PGS normal. The people have spoken.

[Anonymous]

Anonymous wrote:There are a lot of responses now...it's clear that many folks *would* have preferred the chance to transfer some abnormal or perhaps day 3 untested embryos rather than wait for a day 5 PGS normal. The people have spoken.

This is op again. Right- I think I would have preferred keeping the abnormals and sorting the whole bunch- plant the normals first, and then be able to decide with the others. Having that choice taken away, perhaps unnecessarily, and without any discussion of alternatives, is what has really upset me.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

I would freeze any blasts I get. You have already tested several times. It's time to try something different

I would transfer 2-3 on day 2-3 and then freeze any others that become blasts. You still have three "healthy" blasts on ice for future FETs.

This is what I would do too.

[Anonymous]

Anonymous wrote:

Anonymous wrote:There are a lot of responses now...it's clear that many folks *would* have preferred the chance to transfer some abnormal or perhaps day 3 untested embryos rather than wait for a day 5 PGS normal. The people have spoken.

This is op again. Right- I think I would have preferred keeping the abnormals and sorting the whole bunch- plant the normals first, and then be able to decide with the others. Having that choice taken away, perhaps unnecessarily, and without any discussion of alternatives, is what has really upset me.

i have also seen on this forum several times people say "we did PGS testing and there was no a single normal embryo so we moved to donor eggs". sometimes these people had a lot of abnormal embryos. quantity in this context is very important, too.

[Anonymous]

Heartbreaking

[Anonymous]

Please remember also that SG really cares about their stats. Lots of transfers with "abnormal" embryos could reduce their stats if they fail to result in a pregnancy. So in some respects, they are also thinking about their business.

[Anonymous]

Anonymous wrote:Please remember also that SG really cares about their stats. Lots of transfers with "abnormal" embryos could reduce their stats if they fail to result in a pregnancy. So in some respects, they are also thinking about their business.

Yes, this is a really good point. I have always thought they were too conservative, especially for tricky cases.

[Anonymous]

Anyone at a top clinic right now? CCRM, Cornell? I wonder what their take is on it.

[Anonymous]

Anonymous wrote:Please remember also that SG really cares about their stats. Lots of transfers with "abnormal" embryos could reduce their stats if they fail to result in a pregnancy. So in some respects, they are also thinking about their business.

It's also a matter of ethics. Are you really serving well if you are transferring abnormal embryos that are mostly not going to work?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Please remember also that SG really cares about their stats. Lots of transfers with "abnormal" embryos could reduce their stats if they fail to result in a pregnancy. So in some respects, they are also thinking about their business.

It's also a matter of ethics. Are you really serving well if you are transferring abnormal embryos that are mostly not going to work?

how about - let the patient decide? instead of relentlessly pushing donor eggs.