Hi Ladies! Met with Oregon Reproductive and here's what Dr. Hesla says on Genetic Testing

Hi Ladies! Met with Oregon Reproductive and here's what Dr. Hesla says on Genetic Testing

Holly
Holly

August 9th, 2012, 3:04 pm #1

Hi Guys:

I followed up on MIR's advice and met with Dr. Hesla of Oregon Reproductive yesterday. I asked him why their numbers for DOR are so much better then other clinics and he stated that they are genetic testing most of their embryos prior to transfer. They're waiting till day 5 to test and they are sampling from the placenta, not the embryo. He says it's very similar to early pregnancy testing with CVS. Due to the amount of time it takes to receive the results, they freeze the eggs and transfer on a different cycle but his results are impressive. If they can retrieve good eggs, those eggs have a 90% chance of making it through the thawing process and a 70% chance of live birth.

I always thought fresh cycles were much better then frozen but maybe that's just a difference in labs. Also, I was under the impression that genetic testing compromised the egg integrity but Dr. Hesla commented that they have found quite the contrary. By implementing this procedure they have increased their success rates in women our age with our diagnosis. After going through 2 miscarriages with one resulting in a spontaneous abortion I can tell you that I definitely want to thwart that at all costs.

Obviously this route is more expensive and will probably limit the amount of cycles I can do (financially) but if my odds are better maybe it's a safer route?? Just wanted to get all your thoughts. I didn't get this message at all from Seattle Reproductive. They felt it wouldn't improve success and could hurt what good eggs I have. Interesting!



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Joined: August 6th, 2011, 6:43 am

August 9th, 2012, 6:57 pm #2

Glad you met with the ORM doctors for comparison. I honestly don't know which route you should take. When I was at SRM I never got a lot of eggs. So, they transferred all the embryos I got on day three. That made sense in my situation. I don't know if any of my embryos would have made it to day five. They look at each situation differently and determine the best odds with a day three or day five transfer.

This is really interesting they test the placenta, not the embryo. I hope you have some nice healthy eggs
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Mrs. A
Mrs. A

August 9th, 2012, 7:39 pm #3

Hi Guys:

I followed up on MIR's advice and met with Dr. Hesla of Oregon Reproductive yesterday. I asked him why their numbers for DOR are so much better then other clinics and he stated that they are genetic testing most of their embryos prior to transfer. They're waiting till day 5 to test and they are sampling from the placenta, not the embryo. He says it's very similar to early pregnancy testing with CVS. Due to the amount of time it takes to receive the results, they freeze the eggs and transfer on a different cycle but his results are impressive. If they can retrieve good eggs, those eggs have a 90% chance of making it through the thawing process and a 70% chance of live birth.

I always thought fresh cycles were much better then frozen but maybe that's just a difference in labs. Also, I was under the impression that genetic testing compromised the egg integrity but Dr. Hesla commented that they have found quite the contrary. By implementing this procedure they have increased their success rates in women our age with our diagnosis. After going through 2 miscarriages with one resulting in a spontaneous abortion I can tell you that I definitely want to thwart that at all costs.

Obviously this route is more expensive and will probably limit the amount of cycles I can do (financially) but if my odds are better maybe it's a safer route?? Just wanted to get all your thoughts. I didn't get this message at all from Seattle Reproductive. They felt it wouldn't improve success and could hurt what good eggs I have. Interesting!


How do you test the placenta of a day 5 embryo that hasn't been transferred??? The placenta is an organ that develops once pregnancy has been achieved.
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Raindrops1
Raindrops1

August 9th, 2012, 7:48 pm #4

Now I'm confused. They have to be testing something else, can't be the placenta yet.
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Anonymous
Anonymous

August 9th, 2012, 9:24 pm #5

By the time an embryo is a blast, there are different groups of cells, the inner mass and outer mass - one group becomes the placenta and another becomes the fetus. When you see blast grading there is usually a number and two letters (example 4AB): one letter grade is for the inner mass, one for the outer mass.

I believe Holly is saying they only sample the cells destined to be the placenta, similar to CVS testing where only the placenta cells are taken, not the fetal cells.

This is how some clinics are doing genetic testing on embryos now, but it takes a good lab since the embryos are frozen after biopsy. MIR could probably tell more, this is how CCRM does testing too with good results.
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Joined: December 20th, 2010, 7:38 pm

August 9th, 2012, 9:53 pm #6

Hi Guys:

I followed up on MIR's advice and met with Dr. Hesla of Oregon Reproductive yesterday. I asked him why their numbers for DOR are so much better then other clinics and he stated that they are genetic testing most of their embryos prior to transfer. They're waiting till day 5 to test and they are sampling from the placenta, not the embryo. He says it's very similar to early pregnancy testing with CVS. Due to the amount of time it takes to receive the results, they freeze the eggs and transfer on a different cycle but his results are impressive. If they can retrieve good eggs, those eggs have a 90% chance of making it through the thawing process and a 70% chance of live birth.

I always thought fresh cycles were much better then frozen but maybe that's just a difference in labs. Also, I was under the impression that genetic testing compromised the egg integrity but Dr. Hesla commented that they have found quite the contrary. By implementing this procedure they have increased their success rates in women our age with our diagnosis. After going through 2 miscarriages with one resulting in a spontaneous abortion I can tell you that I definitely want to thwart that at all costs.

Obviously this route is more expensive and will probably limit the amount of cycles I can do (financially) but if my odds are better maybe it's a safer route?? Just wanted to get all your thoughts. I didn't get this message at all from Seattle Reproductive. They felt it wouldn't improve success and could hurt what good eggs I have. Interesting!


Be it CCRM, ORM, or even Kato from Japan, the FET rate is always better, even with UNTESTED blasts.

Here is the reason. First of all, you must make high grade blasts before your blast can be frozen. My clinic, L.ife, only freezes blasts above 3bb, if you make 3cc, you are outta luck. Early blasts or compacting morulas won't be frozen. This is pretty much the same standard as all other clinics with a strong FET practice. The high grade blasts have a much better chance of surviving intact after thaw.

Second, your uterus is in a much more receptive state when your body is not pumped with hormone.

However, this does NOT up your chance of live birth, this ups the chance per transfer for live birth. It is still UP TO YOUR OVARIES to produce the high grade blasts! If you can produce quite a number of high grade blasts, yes, this is definitely the way to go. In the end, it is still about YOU.

Btw, the 90% thaw survival rate is a bit low, my clinic runs at 97%. I am just curious if he is saying 90%ish or 90%, because 90% thaw survival is mediocre at best. You'd expect 95% at least. HFI is running at 95%, and CCRM claims 98%.
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Joined: December 20th, 2010, 7:38 pm

August 9th, 2012, 9:56 pm #7

Hi Guys:

I followed up on MIR's advice and met with Dr. Hesla of Oregon Reproductive yesterday. I asked him why their numbers for DOR are so much better then other clinics and he stated that they are genetic testing most of their embryos prior to transfer. They're waiting till day 5 to test and they are sampling from the placenta, not the embryo. He says it's very similar to early pregnancy testing with CVS. Due to the amount of time it takes to receive the results, they freeze the eggs and transfer on a different cycle but his results are impressive. If they can retrieve good eggs, those eggs have a 90% chance of making it through the thawing process and a 70% chance of live birth.

I always thought fresh cycles were much better then frozen but maybe that's just a difference in labs. Also, I was under the impression that genetic testing compromised the egg integrity but Dr. Hesla commented that they have found quite the contrary. By implementing this procedure they have increased their success rates in women our age with our diagnosis. After going through 2 miscarriages with one resulting in a spontaneous abortion I can tell you that I definitely want to thwart that at all costs.

Obviously this route is more expensive and will probably limit the amount of cycles I can do (financially) but if my odds are better maybe it's a safer route?? Just wanted to get all your thoughts. I didn't get this message at all from Seattle Reproductive. They felt it wouldn't improve success and could hurt what good eggs I have. Interesting!


By day 5/6, when your embryo grows to become a blast, the cells are divided into

1) Inner cell mass - which later becomes the baby
2) trophoblast - the part that becomes placenta

You can just biopsy the trophoblast.

However, here comes the trick. There are already papers pointing out that the representation of mosaicsm is much higher in the trophoblast layer, and ICM could be very normal when trophoblast returns result of abnormalty. As a result, you may get false negative.

The trophoblast testing is standard practice for all day 5 genetic testing, nothing special with CCRM or ORM or RMANJ, all the clinics that offer day 5 testing do the same thing.
Last edited by miraclex2 on August 9th, 2012, 10:01 pm, edited 1 time in total.
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Joined: August 6th, 2011, 6:43 am

August 9th, 2012, 10:48 pm #8

Hi Guys:

I followed up on MIR's advice and met with Dr. Hesla of Oregon Reproductive yesterday. I asked him why their numbers for DOR are so much better then other clinics and he stated that they are genetic testing most of their embryos prior to transfer. They're waiting till day 5 to test and they are sampling from the placenta, not the embryo. He says it's very similar to early pregnancy testing with CVS. Due to the amount of time it takes to receive the results, they freeze the eggs and transfer on a different cycle but his results are impressive. If they can retrieve good eggs, those eggs have a 90% chance of making it through the thawing process and a 70% chance of live birth.

I always thought fresh cycles were much better then frozen but maybe that's just a difference in labs. Also, I was under the impression that genetic testing compromised the egg integrity but Dr. Hesla commented that they have found quite the contrary. By implementing this procedure they have increased their success rates in women our age with our diagnosis. After going through 2 miscarriages with one resulting in a spontaneous abortion I can tell you that I definitely want to thwart that at all costs.

Obviously this route is more expensive and will probably limit the amount of cycles I can do (financially) but if my odds are better maybe it's a safer route?? Just wanted to get all your thoughts. I didn't get this message at all from Seattle Reproductive. They felt it wouldn't improve success and could hurt what good eggs I have. Interesting!


I've never had a frozen cycle or embryo testing so thanks for explaining how it all works.
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Mrs. A
Mrs. A

August 10th, 2012, 12:03 am #9

By day 5/6, when your embryo grows to become a blast, the cells are divided into

1) Inner cell mass - which later becomes the baby
2) trophoblast - the part that becomes placenta

You can just biopsy the trophoblast.

However, here comes the trick. There are already papers pointing out that the representation of mosaicsm is much higher in the trophoblast layer, and ICM could be very normal when trophoblast returns result of abnormalty. As a result, you may get false negative.

The trophoblast testing is standard practice for all day 5 genetic testing, nothing special with CCRM or ORM or RMANJ, all the clinics that offer day 5 testing do the same thing.
Thx for explaining. That makes sense that it's precursor cells.
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Liz Portland OR
Liz Portland OR

August 10th, 2012, 1:34 am #10

Hi Guys:

I followed up on MIR's advice and met with Dr. Hesla of Oregon Reproductive yesterday. I asked him why their numbers for DOR are so much better then other clinics and he stated that they are genetic testing most of their embryos prior to transfer. They're waiting till day 5 to test and they are sampling from the placenta, not the embryo. He says it's very similar to early pregnancy testing with CVS. Due to the amount of time it takes to receive the results, they freeze the eggs and transfer on a different cycle but his results are impressive. If they can retrieve good eggs, those eggs have a 90% chance of making it through the thawing process and a 70% chance of live birth.

I always thought fresh cycles were much better then frozen but maybe that's just a difference in labs. Also, I was under the impression that genetic testing compromised the egg integrity but Dr. Hesla commented that they have found quite the contrary. By implementing this procedure they have increased their success rates in women our age with our diagnosis. After going through 2 miscarriages with one resulting in a spontaneous abortion I can tell you that I definitely want to thwart that at all costs.

Obviously this route is more expensive and will probably limit the amount of cycles I can do (financially) but if my odds are better maybe it's a safer route?? Just wanted to get all your thoughts. I didn't get this message at all from Seattle Reproductive. They felt it wouldn't improve success and could hurt what good eggs I have. Interesting!


Hello I am in Portland and if you ever want to chat or meet up I'd love to.
With Dr Hesla we got a bfp & had our DS.
I also know of an amazing acupuncturist in Beaverton....

Email me I you want to chat...
Love & baby dust to all,
Liz
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