Does Your Clinic Do PBB or PGD Before Implanting?

[Anonymous]

I went to SG and got pg with a singleton. However, OB says this is a bad pg as it looks like baby may have a serious chromosomal abnormality. I am frustrated that we went through all this effort only to now possibly miscarry when I feel they could have done some kind of testing beforehand to know if the embryo's they were implanting were of poor quaility.

Nobody offered to do polar body biopsy or PGD. Did you have this done and, if so, which clinic do you go to?

We are looking for a new clinic if this turns out to be a truly unhealthy pg.

[Anonymous]

How many eggs did you get? How many fertilized? How many were there on cd3?

My understanding is that pgd is really only helpful if you have A LOT of embryos to test.

[Anonymous]

just an aside, did you do cvs or an amnio?

[Anonymous]

my understnading is those genetic tests (PGD) are good for things like cystic fibrosis, tay saks, sickel cell and things of that nature that are genetically passed on; it is not a diagnostic for many chromosonal abnormalities and therefore is not equivalent to a CVS or amnio. Nevertheless, it's awful that you have to go through this -- i had to terminate a pregnancy recently and it was a heartbreaking and terrible experience. i feel for you. hope it turns out to be a false alarm.

[Anonymous]

PGD is not the end all be all. As PP says, it is usually done when you are dealing with a specific issue. That being said, after multiple chemical pregnancies, SG did recommend PGD for me. In my case, they tested for the 10 most common chromosonal causes of miscarriage (cannot remember the specific chromosomes they tested).

When an embryo is about 3 days old, they remove 1-2 cells for testing. Note that the embryo may be damaged during this process. Also note that it is possible that not all the cells in the embryo contain the same number of chromosones at this stage -- so it is possible that the cells that they test do not acurately represent what will actually be the genetic makeup of the fetus down the road (I think this is called mosaicism).

Anway, when we had PGD done, we were told that it is only 90% accurate -- that there is a 10% chance that the diagnosis (either favorable or unfavorable) could be wrong.

That being said, I have had multiple successful pregnancies following IVF with PGD. I also miscarried a pregnancy following IVF with PGD. In that case, I'm not sure if we were dealing with a case of mosaicism or if the cause was one of the chromosomes they did not test, or something else. I know how hard it is to suffer a miscarriage and I am sorry you went through that.

I don't know your specific situation, but I would discuss PGD with your RE and see whether or not they think you are a candidate for PGD.

[Anonymous]

Anonymous wrote:How many eggs did you get? How many fertilized? How many were there on cd3?

My understanding is that pgd is really only helpful if you have A LOT of embryos to test.

OP here. I got only 6 eggs, three of which fertilized normally and were implanted.

Why is PGD only helpful if the patient has a lot of embryo's? If all three embies were found to be abnormal naturally we would not have wanted any of them implanted at all.

[Anonymous]

Anonymous wrote:just an aside, did you do cvs or an amnio?

I'm 8w along. Waiting for 10th week to do Nuchal test. 11th week for CVS or amnio.

[Anonymous]

Anonymous wrote:my understnading is those genetic tests (PGD) are good for things like cystic fibrosis, tay saks, sickel cell and things of that nature that are genetically passed on; it is not a diagnostic for many chromosonal abnormalities and therefore is not equivalent to a CVS or amnio. Nevertheless, it's awful that you have to go through this -- i had to terminate a pregnancy recently and it was a heartbreaking and terrible experience. i feel for you. hope it turns out to be a false alarm.

DH and I had no genetic issues acc to results of bloodwork. So is polar body biopsy the only way to pick up chromosomal abnormalities then?

[Anonymous]

not sure what PBB is but i know that CVS and amnio are the only diagnostic tests available -- there are many screens available -- the nuchal etc but they are not diagnostic tests. my question is - how can your OB tell at this early stage? 8 weeks is awfully early to tell any malformations esp if the heart beat is strong. perhaps they're noticing a slow down in growth but i've never heard of a definitive satement like from an ob this early on. just trying to stay positive for you...

[Anonymous]

OB saw heart rate go from 110 last week to 90 this week. OB also said that the fetus is very tiny for his gestational age. He says this is what usually happens before these fetuses miscarry. He said he's seen situations where fetuses miraculously recover but not often.

I began with a high beta, which some studies apparently associate with chromo abnormalities too.

[Anonymous]

I have a friend who had PGD on her embryos-she was at George Washington. From what she told me, they tested for Trisomies and other common genetic diseases. It's not standard procedure for a fertility to perform PGD-my friend was in her 40s and she had to pay for it, in addition to the IVF.

I had a CVS, I was 43 when I had my son, and it covered over 2,500 chromosomal abnormalities. You do have to wait until 11 weeks though and I had several pregnancies that didn't make it to the 11th week.

[Anonymous]

RE told me if I miscarry it would be before week 13. He said 99% of down syndrome fetuses do miscarry, however. 1% are consistent with life and survive. I do, to some degree, expect I will have some problems because of my advanced age. If I miscarry I would not be surprised. But the longer it takes for the miscarriage to take place the harder I think it's going to be for me.

However, RE told me that if the hb is heard, there is a 25% chance of miscarriage (positive flip side is 75% of it working out).

If I make it to week 11, I will do CVS too. Amnio's risk of miscarriage worries me. I'm also not keen on having a long needle inserted into me! Was the CVS terribly uncomfortable?

[Anonymous]

CVS can be long needle in the belly too, it depends on if it's done transvaginally or transabdomanally. I've had it done twice via the belly and it was totaly fine (painwise) -- Dr. Pinckert at Greater Washington Maternal Fetal Medicine is fabulous. He uses a topical anesthetic which helps too. Miscarriage rates, in this area, due to CVS or amnio are very low if you go to someone reputable -- which of course you would as there are quite a few around here who are great. Dr. Karson is another terrific doc. I also had bad news delivered to me with Dr. Pinckert and he and his staff were phenomenal -- i could not have been in better hands physically or emotionally. The blood test/screen at 10 weeks will probably tell you a lot and you may even be able to get that a little sonner -- 9 weeks? I think i had it done closer to 9. Unfortunately, i agree -- the longer you have to wait (IF you are going to miscarry) the harder it will be. Take care of yourself.

[Anonymous]

I had my CVS at Thomas Jefferson in Phili. The RE I was seeing suggest TJ and so we made the trek from DC. His wife was AMA when she got pregnant with their son and how could I not trust my RE TJ were pioneers in the procedure. Anywhoo, the procedure itself wasn't painful, more uncomfortable, but I've only had one and it was through my cervix. The fast test, the 2 day prelim, gave us great news in 2 days, and then 2 weeks later, got the final.

I've m/c at 11 weeks and it sucked. Had to have a D&C and my period didn't come back for almost 6 weeks. When I was TTC, I used to pray that if I were to m/c, I wanted it to happen early, rather than later. I felt it was easier to deal with at 6 weeks than 11.

[Anonymous]

Anonymous wrote:I went to SG and got pg with a singleton. However, OB says this is a bad pg as it looks like baby may have a serious chromosomal abnormality. I am frustrated that we went through all this effort only to now possibly miscarry when I feel they could have done some kind of testing beforehand to know if the embryo's they were implanting were of poor quaility.

Nobody offered to do polar body biopsy or PGD. Did you have this done and, if so, which clinic do you go to?

We are looking for a new clinic if this turns out to be a truly unhealthy pg.

Sorry for your situation. I think the simple answer to your question is that it is not routine to do these tests pre-implantation. No clinic I know does it without some genetic reason to do so. I am sure you could ask for the procedures, but don't blame the clinic for not suggesting them. And I do think the tests are risky to the embryos.