Should I do PGS on my frozen embryos?

[Anonymous]

3 frozen embryos, harvested at age 29, successful pregnancy from that cycle.

Fast forward 3 years later, I conceived naturally and then miscarried. Genetic testing revealed cause due to chromosomal abnormalities.

I desire to try a FET but am not sure if it's worth it to spend the extra money for PGS? RE thinks we do not need to.

Has anyone been in a similar situation?

[Anonymous]

We had a bunch of embryos to test and ended up doing pgs. I wanted to know if a transfer didn't work that it wasn't for chromosomal reasons. I also didn't want to go through with a transfer and meds if there was a great chance it wouldn't work than if we had done pgs.

You already had a failed transfer so you know how you feel on that front. If you can handle that again then maybe don't do it. However I would do it be sure then you have less to worry about in early pregnancy.

This sounds horrible but I viewed it as we were paying 5k to not have a miscarriage for chromosomal reasons and to not have a Down's syndrome baby.

[Anonymous]

How much is it to test and how much is a cycle? Just because you do PGS, that doesn't mean it is a guarantee it will stick.

[Anonymous]

Hi, OP. DW and I were in a similar situation a few years ago. She did a cycle at Shady Grove and we ended up with two embryos that made it to blast. We transferred one and froze the other. The first transfer took, but we lost the pregnancy due to chromosomal abnormalities. At that point we decided to test the remaining embryo, which required thawing it, doing a biopsy, then refreezing while we waited for results. Although the embryo was normal, we believe that the freeze/thaw/freeze/thaw, as well as the biopsy, really interfered with successful implantation. It was only 80% thawed and it didn't stick. Makes me really wish we'd never tested it, and that we had just transferred.

For what it's worth, my DW recently became a patient of Dr. Braverman. Among other things, he told us that when she does her next cycle, we should do a freeze all and NOT test them. He also told us that while PGS does identify chromosomal abnormalities, there are also instances where PGS tested "abnormal" embryos are not, in fact, abnormal (based on a small study he did with his own patients). He also said that the biopsy can do more harm than good in some cases. Now, if you're a person with like 20 embryos, then I could see the sense in testing to at least narrow down what to transfer. However, if you only have a few - which will likely be the case for us (if we're lucky) - it doesn't necessarily make sense to test them.

[Anonymous]

Anonymous wrote:Hi, OP. DW and I were in a similar situation a few years ago. She did a cycle at Shady Grove and we ended up with two embryos that made it to blast. We transferred one and froze the other. The first transfer took, but we lost the pregnancy due to chromosomal abnormalities. At that point we decided to test the remaining embryo, which required thawing it, doing a biopsy, then refreezing while we waited for results. Although the embryo was normal, we believe that the freeze/thaw/freeze/thaw, as well as the biopsy, really interfered with successful implantation. It was only 80% thawed and it didn't stick. Makes me really wish we'd never tested it, and that we had just transferred.

For what it's worth, my DW recently became a patient of Dr. Braverman. Among other things, he told us that when she does her next cycle, we should do a freeze all and NOT test them. He also told us that while PGS does identify chromosomal abnormalities, there are also instances where PGS tested "abnormal" embryos are not, in fact, abnormal (based on a small study he did with his own patients). He also said that the biopsy can do more harm than good in some cases. Now, if you're a person with like 20 embryos, then I could see the sense in testing to at least narrow down what to transfer. However, if you only have a few - which will likely be the case for us (if we're lucky) - it doesn't necessarily make sense to test them.

OP here, thanks for your post. This is my biggest concern - that our embryos are normal but that we'd lose some due to the stress of biopsy, and then not have any at all to transfer! I guess it's weighing the risk of possible miscarriage due to chromosomal issues, or risk of not having any remaining frozen embryos to transfer. That's a tough one...

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hi, OP. DW and I were in a similar situation a few years ago. She did a cycle at Shady Grove and we ended up with two embryos that made it to blast. We transferred one and froze the other. The first transfer took, but we lost the pregnancy due to chromosomal abnormalities. At that point we decided to test the remaining embryo, which required thawing it, doing a biopsy, then refreezing while we waited for results. Although the embryo was normal, we believe that the freeze/thaw/freeze/thaw, as well as the biopsy, really interfered with successful implantation. It was only 80% thawed and it didn't stick. Makes me really wish we'd never tested it, and that we had just transferred.

For what it's worth, my DW recently became a patient of Dr. Braverman. Among other things, he told us that when she does her next cycle, we should do a freeze all and NOT test them. He also told us that while PGS does identify chromosomal abnormalities, there are also instances where PGS tested "abnormal" embryos are not, in fact, abnormal (based on a small study he did with his own patients). He also said that the biopsy can do more harm than good in some cases. Now, if you're a person with like 20 embryos, then I could see the sense in testing to at least narrow down what to transfer. However, if you only have a few - which will likely be the case for us (if we're lucky) - it doesn't necessarily make sense to test them.

OP here, thanks for your post. This is my biggest concern - that our embryos are normal but that we'd lose some due to the stress of biopsy, and then not have any at all to transfer! I guess it's weighing the risk of possible miscarriage due to chromosomal issues, or risk of not having any remaining frozen embryos to transfer. That's a tough one...

PP here. Yes, it's really tough. My DW had to TFMR with the chromosomally abnormal pregnancy, and that was the worst thing that has ever happened to us. Darkest point in our lives, no doubt. I wish I had better advice for you! Good luck to you.

[Anonymous]

The freeze/thaw/biopsy/freeze is too traumatic for the embryos. Don't do it!

[Anonymous]

I skip it and just transfer the ones you have one at a time.

[Anonymous]

We had 4 frozen ones from the same IVF cycle that gave us DD. We did not test them since we did not want to risk damaging them in the thaw/re-freezing process. Did 1 FET that ended in early MC, another FET with BFN. Now on the 3rd FET. We considered testing the remaining ones after the 1st FET since I wanted to avoid another MC, but ultimately decided not running the risk of damaging them was more important for us.

[Anonymous]

Hi, I feel like my position is similar, but in a different order.

At 27, I conceived after about 8 months of TTC, but the pregnancy ended around 15 weeks due to a chromosome abnormality (due to poor sperm). I was told that I was not at an increased risk of miscarriages/chromosome abnormalities, but we found out after about 9 months of TTC following the miscarriage that my husband also has low morphology. We did IVF w/ PGS because I was very fearful that some combination of this miscarriage PLUS low morphology meant that we were at an increased risk of miscarrying again. Our first IVF failed (I think due to triggering too early), but our second one was very successful. Out of 11 day 6 embryos, 9 were normal, 1 abnormal, and 1 inconclusive.

Personally, I would not risk the thaw/biopsy/re-freeze process for the 3 remaining ones. I think, on average, each one has about a 75% chance of being normal, and having 1 miscarriage doesn't put you at an increased risk of abnormalities. I'd rather risk another miscarriage than potentially eliminating viable embryos.

BUT, the choice is entirely yours, and if you need that peace of mind to feel comfortable with the FET, then that is 100% your decision to make. Good luck to you!

[Anonymous]

I would not risk the thaw/test/freeze/thaw/transfer, and I say that as someone who did exactly that, but in my 40s. Since your frozen embryos are from when you were 29, I'd just do the FETs. The chances that all three are abnormal is very low, and the cost to test them along with the stress on the embryos does not outweigh the benefits.

[Anonymous]

New poster with different perspective: I did IVF at age 31. Had 8 frozen blasts. Thawed all, biopsied all. Had 6 normal. Transferred and have a second kid. Have the rest leftover. With vitrification, there's little harm to embryo. I had 8 so I thought I would have a lot of abnormal and didn't want to spend the time, $$ heartache to have negative cycles and possible miscarriage etc. I may do a third kid FET with the normal I have left. They all survived the thaw and refreeze beautifully.

[Anonymous]

Agree that with vitrification, there's very little stress to the embryos. we froze and unfroze ours two times and they were fine- toddler running around now. PGS was great because it helped us avoid another miscarriage. But you are 29 and I was 39 so I could see how you might just do the FET

[Anonymous]

Little stress on the first freeze thaw and biopsy but once you keep doing it, with cell loss, it can be pretty traumatic.

[Anonymous]

I don't know much about PGS testing but if one of the frozen embryos is tested and is fine, it doesn't mean that the rest of the frozen embryos are fine, right?