DH and I had a consultation with my RE today to get the ball rolling on IVF. We don't have any genetic risk factors, but he highly recommended PGD to increase our chances of a successful cycle. I'm curious about your experiences with it. Did you do it? Did you decline? Why? Any insight is appreciated.
If you have no known genetic risk factors, then PGS seems more appropriate than PGD. PGS looks at the chromosomes for abnormalities (such as trisomies), whereas PGD looks at actual genes to identify inherited diseases. Chromosomal abnormalities can happen to anyone at any age, though rates do go up as you age. You cannot tell by looking at an embryo if it is chromosomally normal or not. Most chromosomally abnormal embryos will not implant at all, and of those that do, only a few will produce a viable fetus (with life-long health consequences). Trisomy 21, for example, is the cause of Down Syndrome for those babies born alive, but 70% or more of babies with Trisomy 21 will be miscarried naturally (I had no idea the rate of miscarriage was so high until after it happened tome). So... I guess what I am saying is that if you can afford it, PGS is a very useful tool -- it identifies embryos that likely would not implant at all or, if they implanted, would likely end in miscarriage. It can save a lot of money & heartache in the end.
*************Siggy Warning. Loss mentioned.************
Me: 36, DH:37
Married 4/2010, TTC since 7/2011
Dx: Officially Unexplained (I have Polycystic Ovaries diagnosed via ultrasound, but few classic PCOS symptoms, he has mild MF issues. So... not issue free, but nothing so severe as to explain IF)
I also deal with post-surgical Hypothyroidism following Thyroid Cancer in 2009, but under control with Levothyroxine
4 months Clomid (thinned lining) and 10 months Letrozole (every indication that I responded perfectly)
6 failed IUIs in 2013, 3 with trigger
IVF #1 in March
2014
ER 3/21/14, 31R/21F,
12 frosties!
ET 3/26/14, 1 perfect blast transferred: BFN
FET#1 5/28/14, 2 "beautiful" early blasts transferred. BFP!!
Beta #1 (6/11/14) 798; Beta #2 (6/18/14) 7,966.
1st u/s (6/25/14) showed 2 sacs, 1 empty & 1 with a beautiful little bean doing what it needs to do!
We considered CGH testing on our embryos for IVF #3, but decided not to go through with it because we only ended up with 2 blasts. We just decided to transfer both. It didn't seem worth the extra expense to test only 2 blasts and at the time we had planned on it being our last IVF cycle. Looking back it would have been nice to know if that transfer failed because our embryos were aneuploid, but at the time I think we made the right decision. Personally I don't feel like it is necessary for your first IVF, unless you have some known risk factor (age or RPL).
DH (32): SA is ok, slightly low morph, normal SCSA Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA
October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos
November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues. Converted to freeze all due to lining issues. 2 blasts frozen on day 6!
January 2015: FET #2 Cancelled due to lining issues
@Spring78 I think you're correct: PGS sounds correct. I found it very interesting when he mentioned abnormal embryos miscarrying. It does make sense, it's just not something I've ever really had to think about.
@Twinkle0612 I would have probably made the same decision if there were only two blasts.
I was offered IVF w/ PGD testing due to a balanced translocation. I had two CP and was sent for RPL testing. Once the translocation was discovered I was sent to a genetic counselor. I was given a few odds of what the out come would be and my chances of having a normal embryo or an embryo with the same translocation as me that could result in a successful pregnancy and live birth. The odds were pretty low. That was when I decided it wasnt an option that I wanted to go with just due to the odds.
Married in September 2010, started TTC journey November 2012
Me-
7 IUI- 2 CP- 2 BFN
RPL blood work 12/27, showed a balance translocation in chromosome 11;22
Spouse-
PCOS 4 IUI-4 BFN
New Plan: Reciprocal IVF, me as carrier wife's eggs. Just went through insurance and received partial approval, so my part will go through my IVF benefits and wife's part will be out of pocket. Now just finalizing finance plans to cover the oop costs. Doctors office is in process of moving to a new building so there are no IVF start ups until March/April 2015.
Typically they recommend it if you have some genetic reason or repeat losses. We didn't do PgD, but I kind of regret not doing it, as it would have meant that I didn't have my last mc. At the same time, we had reasoned that if we had done pgd we couldn't have afforded an FET for a while...so it was a crap shoot. Prior to ivf I had a cp and a triploidy mmc. First round of ivf I had a tetraploidy. Chances of that are extremely unlikely...so my RE would kill to have genetic results of our 6 frosties...but the man isn't paying, so we didn't. And, at the time, he didn't think it was necessary...However, I apparently am very very weird, so my situation is ABSOLUTELY not normal. Anyway, point is, sometimes, even with normal karyotyping (which we have) it can be useful. But it's expensive...and that's always a factor. It's not an easy decision.
*****loss mentioned ***** When we started on our journey we declined the PGD. Neither H not I have anything in the background of our family to raise concern. We had a MMC in April and a D&C. From that we got tissue from one of the twins and she was chromosomally normal.
Then we changed REs and took our remaining 6 embies with us. Before my last transfer we thawed all 6 and had PGD done. Of those 6, 1 had turners syndrome and the remaining 5 were normal.
My H looked at it like a Percentage of risk. I just see it as we had one known unhealthy embryo. And that eliminated our chance for having another MC or having to make a decision we don't want to make because the fetus isn't viable. No hope that makes sense.
GL on your journey.
Me: 38 DX: Adenomyosis, Compounded MTHFR, PAI-1 4G variant DH: 34 MFI due to Testicular Cancer
Married March 2012 IVF w/ICSI #1 10 little polar bears FET #1 with 2 polar bears ~Nov 6, 2013 BFN FET # 2 with 2 more polar bears ~March 19, 2014 BFP!!! Beta 1= 276 Beta 2= 662 4/19/14 ~ baby A became an angel 5/02/14 ~ baby B became an angel 5/3/14 ~ D&C FET #3 with 1 male polar bear ~October 3, 2014 October 13, 2014 ~ BFN Fur Children: Memphis 3y, Dutch 3y, Marcel 2y, Meadow 1y
January 2015 Siggy Challenge TTCAL Animals Interacting with Snow
Re: PGD?
*************Siggy Warning. Loss mentioned.************
Me: 36, DH:37
Married 4/2010, TTC since 7/2011
Dx: Officially Unexplained (I have Polycystic Ovaries diagnosed via ultrasound, but few classic PCOS symptoms, he has mild MF issues. So... not issue free, but nothing so severe as to explain IF)
I also deal with post-surgical Hypothyroidism following Thyroid Cancer in 2009, but under control with Levothyroxine
4 months Clomid (thinned lining) and 10 months Letrozole (every indication that I responded perfectly)
6 failed IUIs in 2013, 3 with trigger
IVF #1 in March 2014
ER 3/21/14, 31R/21F, 12 frosties!
ET 3/26/14, 1 perfect blast transferred: BFN
FET#1 5/28/14, 2 "beautiful" early blasts transferred. BFP!!
Beta #1 (6/11/14) 798; Beta #2 (6/18/14) 7,966.
1st u/s (6/25/14) showed 2 sacs, 1 empty & 1 with a beautiful little bean doing what it needs to do!
EDD 2/14/15, missed miscarriage, DX: Trisomy 21. D&C 8/1/14
FET#2 Transferred 3 embies, 2 looking pretty good, one not so much. BFN.
IVF#2 January 2015, tentative ER 1/23
We considered CGH testing on our embryos for IVF #3, but decided not to go through with it because we only ended up with 2 blasts. We just decided to transfer both. It didn't seem worth the extra expense to test only 2 blasts and at the time we had planned on it being our last IVF cycle. Looking back it would have been nice to know if that transfer failed because our embryos were aneuploid, but at the time I think we made the right decision. Personally I don't feel like it is necessary for your first IVF, unless you have some known risk factor (age or RPL).
TTC #1 since August 2011
My Blog
September 2012: Start IF testing
DH (32): SA is ok, slightly low morph, normal SCSA Me (32): Slightly low progesterone, hostile CM, carrier for CF, Moderately high NKC, High TNFa, heterozyogous mutated Factor XIII, and +APA
October 2012-May 2014: 4 failed IUIs, 3 failed IVFs, and 1 failed FETw/donor embryos
November 2014: IVF w/ICSI #4 Agonist/Antagonist with EPP and Prednisone, Baby Aspirin, Lovenox, and IVIG for immune issues. Converted to freeze all due to lining issues. 2 blasts frozen on day 6!
January 2015: FET #2 Cancelled due to lining issues
April 2015: FET #2.1
PAIF/SAIF Welcome!
Married in September 2010, started TTC journey November 2012
Me-
7 IUI- 2 CP- 2 BFN
RPL blood work 12/27, showed a balance translocation in chromosome 11;22
Spouse-
PCOS 4 IUI-4 BFN
New Plan: Reciprocal IVF, me as carrier wife's eggs. Just went through insurance and received partial approval, so my part will go through my IVF benefits and wife's part will be out of pocket. Now just finalizing finance plans to cover the oop costs. Doctors office is in process of moving to a new building so there are no IVF start ups until March/April 2015.
*losses mentioned*
Typically they recommend it if you have some genetic reason or repeat losses. We didn't do PgD, but I kind of regret not doing it, as it would have meant that I didn't have my last mc. At the same time, we had reasoned that if we had done pgd we couldn't have afforded an FET for a while...so it was a crap shoot. Prior to ivf I had a cp and a triploidy mmc. First round of ivf I had a tetraploidy. Chances of that are extremely unlikely...so my RE would kill to have genetic results of our 6 frosties...but the man isn't paying, so we didn't. And, at the time, he didn't think it was necessary...However, I apparently am very very weird, so my situation is ABSOLUTELY not normal. Anyway, point is, sometimes, even with normal karyotyping (which we have) it can be useful. But it's expensive...and that's always a factor. It's not an easy decision.
When we started on our journey we declined the PGD. Neither H not I have anything in the background of our family to raise concern. We had a MMC in April and a D&C. From that we got tissue from one of the twins and she was chromosomally normal.
Then we changed REs and took our remaining 6 embies with us. Before my last transfer we thawed all 6 and had PGD done. Of those 6, 1 had turners syndrome and the remaining 5 were normal.
My H looked at it like a Percentage of risk. I just see it as we had one known unhealthy embryo. And that eliminated our chance for having another MC or having to make a decision we don't want to make because the fetus isn't viable. No hope that makes sense.
GL on your journey.
DX: Adenomyosis, Compounded MTHFR, PAI-1 4G variant
DH: 34
MFI due to Testicular Cancer
Married March 2012
IVF w/ICSI #1
10 little polar bears
FET #1 with 2 polar bears ~Nov 6, 2013 BFN
FET # 2 with 2 more polar bears ~March 19, 2014 BFP!!!
Beta 1= 276
Beta 2= 662
4/19/14 ~ baby A became an angel
5/02/14 ~ baby B became an angel
5/3/14 ~ D&C
FET #3 with 1 male polar bear ~October 3, 2014
October 13, 2014 ~ BFN
Fur Children: Memphis 3y, Dutch 3y, Marcel 2y, Meadow 1y
January 2015 Siggy Challenge TTCAL
Animals Interacting with Snow