CGH testing of embryos?

darby17

Hello ladies,

I would love some input from anyone who has experience with CGH or genetic testing of embryos.  My Dr. suggested that for this next IVF cycle that we go ahead and fertilize my eggs.  Biopsy them on day 5 (if they get that far) and send them off for genetic testing. We hadn't talked about this option before, so I am trying to find out as much as I can about the process, the benefits, costs, risks, etc.   It sounds like a good idea to me, however, since I am DOR - I don't have an abundance of eggs to work with.  The nurse told me that one risk is that we don't get to transfer day - (if there are no embryos that make it).  That would be sad, but I am thinking that if they didn't make it to day 5, odds are they wouldn't develop into a healthy baby anyway?

 

chucktgirl

I am unfamiliar with CGH, but I did PGS. Maybe they're similar? In my situation, they send a sample of the fertilized embryos out for testing on Day 3, to prepare for a Day 5 transfer. Unfortunately, all of embryos tested as having "severe abnormalities" so there was nothing to transfer on Day 5. Mind you, they gave me the results as I was at the Dr. office waiting to have the transfer procedure. Heartbreaking. For my next cycle (this month) my RE has recommended that I forego genetic testing at all and simply transfer all embryos that are still viable on Day 3, just to give me the best chance of getting pregnant. His reasoning is that some embryos simply don't like to grow outside the womb, whereas they may have stood a chance in my uterus. Also, he doesn't want the 5% odds that the PGS testing can give a false positive for abnormalities, which means that we might be throwing away good embryos that mistakenly tested bad. This was very hard news for me to hear, as it is very important to both of us that we do the testing. Yet, as a double-edged sword, I want to be PG so bad, that why wouldn't I want to give myself the best shot at it? We thought about it alot (and still do) and decided that we are going against RE's advice and having the PGS done again (if I'm lucky enough to produce enough eggs!). This is not a light decision. You can add to it that each PGS test we do cost us $3800 out of pocket. We are not wealthy. Anyway, it is an incredibly difficult decision. I guess the best you can do is follow your heart/gut feeling with this one. Good luck to you!

BAKERMOMHDS

Hi Darby17

I did CGH testing with IVF#3.  I'll try to sum up "our story" and I stress "our story" I really feel all of us have a unique IF journey, and our reasons for selecting CGH may not be right for someone else.

Our first IVF cycle I had 11 eggs retrieved, 9 fertilized but by day 3 only 2 were good enough for transfer.  So, we transfered 2 on day 3 = BFN

Our second IVF cycle slightly different protocol, 19 eggs retrieved, 17 fertilized only 3 viable at day 3.  So, we transfered 3 on day 3 = BFN

In addition to the two failed IVF cycles I've had 3 miscarriages all under 7wks. Prior to our first IVF cycle I had all the testing for recurrent pregnancy loss, infertility workup, etc, etc. With all testing coming back normal (including full Counsyl genetic testing and Karyotyping on both of us).

Third IVF : we decided to seek a second opinion. At the new clinic / new RE he immediately suggested : 5 day biopsy CGH testing. That scared the heck out of me, we never made it to day 5.  BUT, I was super, super tired of putting back embryos that were not remotely viable.  With my history of miscarriages, 2 failed IVF, and the growth pattern of our embryos from day 1- day 3, the new RE felt this was in our best interest.

We had ONE beautiful blastocyst at day 5/6...he was biopsied and CGH NORMAL!!! (You can image the excitement at our house!!!!!). 

- we chose to send the one single embryo : most folks will tell you don't do it, it's too costly.  Well, for us we needed that information, peace of mind, etc. I'm so glad we did.

- CGH testing at day 5 : Our RE indicated (in his opinion) day 5 testing is less damaging to the embryo > a piece of the outer shell is biopsied instead of removing one entire cell from a 3 day embryo roughly 6-10 cells in mass.

-The freeze / thaw rate at this clinic is really good.  It's not perfect, so we had a small chance our normal embryo would not survive the freeze (and subsequently the thaw when we transfer).

This big long story ends up with IVF#4 : We are using the same protocol (MDLF) with 5 day CGH biopsy. We are praying, hoping, wishing..we find one more normal in my big jar of poor quality eggs.

The CGH testing for both rounds will be performed by reprogenetics (west coast office).

Best of luck to you!

chucktgirl

BAKERMOMHDS:

Hi Darby17

I did CGH testing with IVF#3.  I'll try to sum up "our story" and I stress "our story" I really feel all of us have a unique IF journey, and our reasons for selecting CGH may not be right for someone else.

Our first IVF cycle I had 11 eggs retrieved, 9 fertilized but by day 3 only 2 were good enough for transfer.  So, we transfered 2 on day 3 = BFN

Our second IVF cycle slightly different protocol, 19 eggs retrieved, 17 fertilized only 3 viable at day 3.  So, we transfered 3 on day 3 = BFN

In addition to the two failed IVF cycles I've had 3 miscarriages all under 7wks. Prior to our first IVF cycle I had all the testing for recurrent pregnancy loss, infertility workup, etc, etc. With all testing coming back normal (including full Counsyl genetic testing and Karyotyping on both of us).

Third IVF : we decided to seek a second opinion. At the new clinic / new RE he immediately suggested : 5 day biopsy CGH testing. That scared the heck out of me, we never made it to day 5.  BUT, I was super, super tired of putting back embryos that were not remotely viable.  With my history of miscarriages, 2 failed IVF, and the growth pattern of our embryos from day 1- day 3, the new RE felt this was in our best interest.

We had ONE beautiful blastocyst at day 5/6...he was biopsied and CGH NORMAL!!! (You can image the excitement at our house!!!!!). 

- we chose to send the one single embryo : most folks will tell you don't do it, it's too costly.  Well, for us we needed that information, peace of mind, etc. I'm so glad we did.

- CGH testing at day 5 : Our RE indicated (in his opinion) day 5 testing is less damaging to the embryo > a piece of the outer shell is biopsied instead of removing one entire cell from a 3 day embryo roughly 6-10 cells in mass.

-The freeze / thaw rate at this clinic is really good.  It's not perfect, so we had a small chance our normal embryo would not survive the freeze (and subsequently the thaw when we transfer).

This big long story ends up with IVF#4 : We are using the same protocol (MDLF) with 5 day CGH biopsy. We are praying, hoping, wishing..we find one more normal in my big jar of poor quality eggs.

The CGH testing for both rounds will be performed by reprogenetics (west coast office).

Best of luck to you!

Bakermom, May I ask a couple questions? Why was your one good egg frozen and not transferred? Was it because you want to try to get several to transfer at one time? Do you know if there is a preference of CGH over PGS? I am also concerned that the PGS sampling may damage the embryo. I'm just trying to make the right decisions for us. Good luck to you - you have at least one lucky egg!

BAKERMOMHDS

- the 5 day CGH testing at my clinic is a send out.  So, our blast was biopsied on the morning of the 6th day / Frozen and sent to Reprogenetics in CA. We waited 36 hours for the testing results! (which I thought was SUPER FAST!!)

A couple other factors : The new RE thinks doing a FET in my case might be best. My E2 is always sky high at retrieval and I tend to be a big swollen nightmare mess for about 7 days after ER.

And...we'd like to transfer more than one . (Which I have mixed emotions about, but we are going with the recommendation from this RE, with my age..2 is best for this clinic)

For me (someone with lots of anxiety) focusing on producing the best eggs / embryos possible during a cycle and not focusing on a transfer as well.. was really, really good for my mental state / anxiety. When it's time for transfer, i'll focus all my energy on transferring

darby17

Hi Bakermom,

Thank you so much for sharing. I really appreciate your insight. I notice that we are about the same age. We have an appointment with the genetic counselor next week, but I think we are definitely leaning towards the CGH testing. I had two failed IVFs (both CPs).  We transferred on day three for both previous cycles and had nothing left to freeze. I am worried about nothing making it to day 5 - but I think I agree with you. I am tired of putting back crummy embryos that probably don't have a chance anyway.  Another benefit I was thinking about is that if we do end up pregnant after the CGH testing (please God!) we wouldn't have to worry about genetic testing down the road (amnio, or cvs).

Good luck with your next IVF!!     

PPL2011

My RE is recommending PGS on day 5. She said that on day 5 you test the outer shell (which is to become the placenta?) and the embryo is more or less undisturbed. She sees a big benefit to doing it at my age...I don't know what CGH is. She also said doing PGS on day 5 it's like CVS and would skip it if I was to become pg, and then do the MaterniT 21 blood test....maybe amnio.

Good luck! 

Mrs.McIrish

I think it is hard to test embryos when you are DOR. I was never a candidate for it since I make so few eggs. I think it is a different ball game when you have a lot to choose from but I don't see it being worth the expense with a few. I've always transferred what was still alive (less than 3) so spending thousands to find out what I could "learn" 2 weeks later didn't make sense financially. If you had 20 embryos to pick from, it would be different IMO. 

mamaat43

mamaat43

I am 42 years old. Couple months away from 43. Have history of pregnancy loss at 20 weeks due to genetic abnormalities. Then I had my daughter. Then another miscarriage at 10 weeks.

Decided to do IVF with CGH so we could be sure the embryo was genetically ok. At my age now the risks were very high. The success rate for me with  IVF was about 10% but we still wanted to move forward. I felt optimistic as I had good follicle count (14) and live a very healthy lifestyle. Also had been taking fertility supplements for years and doing acupuncture and massage regularly.

In cycle they were tracking 17 follicles. 12 were retrieved. 10 were mature, 9 fertilized. Of those 9 only 4 embryos made it to day 6 for the CGH testing. ALL were grade 1, flawless embryos.

CGH revealed two were not genetically viable so we were left with 2 genetically healthy, grade one, flawless embryos. We were thrilled! For my age group this was exceptional. Now we wait for frozen transfer. Will be using just one to avoid multiples. For each transfer, of single CGH embryo, we were given 50-60% success rate embryos. So we are feeling optimistic!

Good luck!!!

URMySunshine77

Good luck, @mamaat43!

efhoping2010

We are planning to use CCS testing which I think is similar to CGH with this IVF cycle, fresh #4, since we have an embryo quality problem, see history below.

I just do not want to transfer non-viable embryos any more it is too tough.

reneevocaturo

testing

 

mamaat43

Here is my update. 

With our two, grade one, "flawless", CGH healthy, embryos we were thrilled and optimistic. Lining and all other labs were excellent. I have immunology issues so did intralipid treatments, dethamexasone, acupuncture, as well as gluten and dairy free, whole food diet.

First frozen transfer... total negative beta. ZERO. Devasted.

Second transfer- First beta 4, second 6. Determined chemical pregnancy and I am waiting to bleed it out. 

Very shocking with the 60-70% success rate we were given for each embryo. Neither worked. I wonder if the high success rates for CGH are over-inflated. I know another woman with a similar case, two CGH normal transfers, negative.  Or can this still be blamed on immunology?

Good luck to you all. I really thought this was going to happen for us but time, money and emotions are drained. I am going to try to move on from the ART fertility world and enjoy my life as it is with my one beautiful child.