Genetic testing of embryos - is it an option for low responder?(m'c mentioned)

Genetic testing of embryos - is it an option for low responder?(m'c mentioned)

Julie
Julie

May 25th, 2012, 3:36 am #1

Since I had multiple miscarriages, I asked my RE about genetic testing. He said given my situation (my last IVF, highest dose stipulation, only got two eggs, one mature), it is not worthwhile to do genetic testing. Because even if it is tested normal, i may lose my embryo during the freezing or thawing or incubation whatever.

However, that was before I had another miscarriage. I am so tired and terrified of miscarriage - not only because of the emotional roller coaster, but also it wastes time...

One of my friend told me at CCRM they can do testing as long as I can produce two eggs.

I am just wondering if any of you has some information or opinion about genetic testing. Is it worth it? or it is too risky to lose the only few eggs?

Many thanks!
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Jamie
Jamie

May 25th, 2012, 12:43 pm #2

Hi Julie,
We have talked a lot about this on the 40+ board, so you may want to post there too and ask.

I am so sorry about your miscarriages. I had an early one after my first IVF and it was very hard. I agree with doing whatever you can to avoid that going forward.

Two thoughts:
1) Have you had a recurrent miscarriage panel done? Then should be testing you for every immune issue under the sun. It would also be wise for your husband to have a SCSA test, to see if his sperm's DNA is intact.

2) I completely disagree with your RE. It sounds as if he does not know how to do this and does not use advanced techniques such as vitrification. My clinic thought it was completely no big deal to do this, and in fact my RE said it was a no brainer to genetically test everything I transfer.

My situation is that on my second IVF I had a baby and then had two embryos frozen at the blastocyst stage. Since I will be 41 next month I wanted to know if these embryos are likely to produce a live birth. If they were both abnormal I would have started doing IVF again right away (because of my issues I can't get pregnant without it).

My RE thawed my embryos (which had been frozen through vitrification), took a few cells from the part that becomes the placenta, and then refroze them. Both embryos survived the thaw and biopsy. They were refrozen (vitrified) and the cells were tested using CGH, which tests every chromosome. I found that one embryo is normal and the other is inconclusive. It has given me peace to have a normal one.

I think that you need to look for a new practice that has an advanced lab and offers CGH. You can do your cycle, grow to blast, biopsy, freeze (vitrify) and then get the results. Good luck!
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Whitney
Whitney

May 25th, 2012, 6:31 pm #3

Since I had multiple miscarriages, I asked my RE about genetic testing. He said given my situation (my last IVF, highest dose stipulation, only got two eggs, one mature), it is not worthwhile to do genetic testing. Because even if it is tested normal, i may lose my embryo during the freezing or thawing or incubation whatever.

However, that was before I had another miscarriage. I am so tired and terrified of miscarriage - not only because of the emotional roller coaster, but also it wastes time...

One of my friend told me at CCRM they can do testing as long as I can produce two eggs.

I am just wondering if any of you has some information or opinion about genetic testing. Is it worth it? or it is too risky to lose the only few eggs?

Many thanks!
My RE won't do genetic testing unless you have 3 plus embryos. Have you ever had any testing done on your miscarriages to give you concern?
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Julie
Julie

May 25th, 2012, 7:14 pm #4

Hi Julie,
We have talked a lot about this on the 40+ board, so you may want to post there too and ask.

I am so sorry about your miscarriages. I had an early one after my first IVF and it was very hard. I agree with doing whatever you can to avoid that going forward.

Two thoughts:
1) Have you had a recurrent miscarriage panel done? Then should be testing you for every immune issue under the sun. It would also be wise for your husband to have a SCSA test, to see if his sperm's DNA is intact.

2) I completely disagree with your RE. It sounds as if he does not know how to do this and does not use advanced techniques such as vitrification. My clinic thought it was completely no big deal to do this, and in fact my RE said it was a no brainer to genetically test everything I transfer.

My situation is that on my second IVF I had a baby and then had two embryos frozen at the blastocyst stage. Since I will be 41 next month I wanted to know if these embryos are likely to produce a live birth. If they were both abnormal I would have started doing IVF again right away (because of my issues I can't get pregnant without it).

My RE thawed my embryos (which had been frozen through vitrification), took a few cells from the part that becomes the placenta, and then refroze them. Both embryos survived the thaw and biopsy. They were refrozen (vitrified) and the cells were tested using CGH, which tests every chromosome. I found that one embryo is normal and the other is inconclusive. It has given me peace to have a normal one.

I think that you need to look for a new practice that has an advanced lab and offers CGH. You can do your cycle, grow to blast, biopsy, freeze (vitrify) and then get the results. Good luck!
Thanks for your suggestion. I think now maybe it is a good time to do the genetic testing.

As of freezing embryos, i can see you have at least three embryos. That is the point, I have only one. So I am weighing between losing the embryos because of genetic testing or risking another miscarriage. The problem with me was my poooooor response. My local RE has a decent lab but I don't DOR patients are his specialty. Definitely I will dig into this question further.
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Julie
Julie

May 25th, 2012, 7:18 pm #5

My RE won't do genetic testing unless you have 3 plus embryos. Have you ever had any testing done on your miscarriages to give you concern?
Yeah. Now I see it is because I only had one embryo on high stipulation last time. That is why my RE would not suggest genetic testing. When I heard CCRM would do testing on two embryos, I am thinking whether I should give it try (if I have two embryos to start with).

I didn't have any genetic testing done on my miscarriage. First miscarriage nobody suggested that. Second my ob said testing didn't really tell me anything about future pregnancy anyway. Third it is a biochemical so I don't have the tissue.
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Jamie
Jamie

May 25th, 2012, 9:38 pm #6

Thanks for your suggestion. I think now maybe it is a good time to do the genetic testing.

As of freezing embryos, i can see you have at least three embryos. That is the point, I have only one. So I am weighing between losing the embryos because of genetic testing or risking another miscarriage. The problem with me was my poooooor response. My local RE has a decent lab but I don't DOR patients are his specialty. Definitely I will dig into this question further.
A good lab that does this routinely really should not put your embryo at risk. There is probably a 95+% chance that it would survive biopsy and freeze assuming skill and practice in biopsy and freeze using vitrification. I think it's a great idea to do this in your situation. Then you will know what is finally going on.

Another thought is to bank embryos . . . . do about 3-4 rounds of IVF, freeze your 3 day embryos, then when you are ready, thaw and let them grow to 5 day. Biopsy and freeze again. Then you can test a batch of them. This is how CCRM does it, I believe. My clinic was not concerned with thawing my blasts, biopsying them, freezing again, and then thawing at some point.

Good luck, and again . . . I would not trust your current clinic to do this. I would really get to one with a top notch lab.
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Jamie
Jamie

May 25th, 2012, 9:43 pm #7

Thanks for your suggestion. I think now maybe it is a good time to do the genetic testing.

As of freezing embryos, i can see you have at least three embryos. That is the point, I have only one. So I am weighing between losing the embryos because of genetic testing or risking another miscarriage. The problem with me was my poooooor response. My local RE has a decent lab but I don't DOR patients are his specialty. Definitely I will dig into this question further.
I transferred two and froze two. The two I transferred were not tested. I wanted to test the two that were frozen since I want a sibling for my daughter but I'd rather she be older. Thus, I wanted to know if they were chromosomally normal.

Again, my clinic had no problem testing two and both survived thaw and biopsy . . . . I really wouldn't worry as long as the lab is good and vitrification is used.

I would really get a second opinion from another RE. I just find it odd that you keep having these miscarriages. Many people have one, but three is something else. I read a blog by a woman who had six and now is finally about 20 weeks pregnant. She had to do some heavy duty immune treatment stuff (and she did test all embryos she transferred after a few miscarriages). She went to CCRM. You may find it interesting: http://lifeandloveinthepetridish.blogspot.com/
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Julie
Julie

May 28th, 2012, 6:32 pm #8

Your reply is very informative. I checked the link you provided and it was an encouraging read. I should say it is so nice that she had many embryos for the testing. But definitely I am considering consultation with other REs.

Thanks again!!!
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Sara Q
Sara Q

May 30th, 2012, 10:40 pm #9

Yeah. Now I see it is because I only had one embryo on high stipulation last time. That is why my RE would not suggest genetic testing. When I heard CCRM would do testing on two embryos, I am thinking whether I should give it try (if I have two embryos to start with).

I didn't have any genetic testing done on my miscarriage. First miscarriage nobody suggested that. Second my ob said testing didn't really tell me anything about future pregnancy anyway. Third it is a biochemical so I don't have the tissue.
...but none of our 7 embryos made it from day 3 to day 5. But they did tell us that they would go forward with as few as 2 embryos - but only do PN genetic testing (day 1 or day 5). I'd even bet they'd go forward with one embryo - but that's a very expensive (and emotionally draining.)

Good luck to you.
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Julie
Julie

June 7th, 2012, 12:13 am #10

Thanks for sharing. I am sorry for your experience at CCRM. It must have been emotional draining. I can't imagine if I only have one embryo and lose it in the testing. So it is a very hard decision...
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