Mind-blowing article on transferring of PGS-abnormal embryos

[Anonymous]

https://www.thecut.com/2017/09/ivf-abnormal-embryos-new-last-chance.html

"...researchers have begun to report preliminary but stunning evidence that mammalian embryos with abnormal chromosomes have the remarkable ability in some cases to “self-correct” during early development, either by editing out cells that possess chromosomal irregularities or isolating them in the placenta, where they have no apparent effect on a developing fetus. As a result, these doctors believe that the widespread, long-standing conviction in medicine that abnormal embryos are destined to fail may be scientifically incorrect."

[Anonymous]

That's amazing, thanks for sharing.

[Anonymous]

This is the op: I read this and was at first shocked, but now I'm feeling some mixture of sorrow and rage. We discarded more than half of our embryos during banking, and ended up with 2, one of which ended up in a miscarriage and the other I am currently carrying. The fact that I could have just thrown away three siblings to this baby without anyone mentioning this research to me makes me want to smash everything in sight right now.

[Anonymous]

Op - I am so sorry you are feeling that way. I think that most doctors think that the odds that an embryo can self correct are so low that it isn't worth the cost, heartache, etc. of transferring.

I know that other doctors (such as mine at GW) specifically did not advise us to do PGS testing due to my age at the time the embryos were made (32) and our issue (MF). I do have one DD (20 months) and going back for an FET in a few weeks. I always regretted not doing PGS, but this article does give me some hope that it wouldn't have mattered either way...

[Anonymous]

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.

[Anonymous]

This is not new information. If has been out for awhile and most fertility places know about it. Still, they believe your best shot is with a pgs tested "normal" embryo. This information has actually been out for a couple of years.

[Anonymous]

there's a chance it would self-correct, but is that chance bigger than the chance that you would either miscarry or that you would have a child with severe abnormalities?

[Anonymous]

This is total garbage and PGS has helped many of us have a healthy baby. The error rate in PGS is directly related to the skill of the embryologist doing the biopsy so I encourage everyone to speak to their RE about this information before assuming you discarded good embryos.

[Anonymous]

I've read other articles about mosaicism and issues/concerns with PGA accuracy, and I've thought about this quite a bit. However - This article didn't get into it, but I think that I remember reading that even the doctors who advocate going ahead with genetically abnormal embryos prefer those with aeuploid rather than triploid errors - I guess that there's generally less chance of those embryos surviving, if the correction isn't made.

[Anonymous]

Anonymous wrote:I've read other articles about mosaicism and issues/concerns with PGA accuracy, and I've thought about this quite a bit. However - This article didn't get into it, but I think that I remember reading that even the doctors who advocate going ahead with genetically abnormal embryos prefer those with aeuploid rather than triploid errors - I guess that there's generally less chance of those embryos surviving, if the correction isn't made.

Oops - meant to say that monoploid better than triploid...aneuploid would cover both.

[Anonymous]

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.

[Anonymous]

It is interesting. But as others have said, what's the alternative? Implant non-normals, then do cvs/amnio later to see if they've corrected, then terminate if not? That is a big, time consuming, hard on your body process, too. And as a parent of a child with a rare chromosome disorder (not an IVF cycle), I will say that certainly not every chromosomal error corrects itself or causes miscarriage. It would really be rolling the dice IMO.

[Anonymous]

I also learned that not all Fertility clinics will let you implant abnormal embryos. SGF for instance.

[Anonymous]

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.

[Anonymous]

Ouch. A friend of mine just had three failed cycles because they didn't get a single PGS normal embryo. They tossed so many embryos (she was a surprisingly good responder for her age). I'd guess around 20 blasts were tossed from those cycles.

I always wondered what would happen if she just transferred 3 on day 3.