PGS question

Ash_SE · March 2017

Im on the fence to PGS. Doctor says its up to me but with repeat natural chemicals in addition to the ectopic it's worth doing. However I'm worried I won't have that many embryos make it to day 5 blast stage for the biopsy amd freeze for PGS. I would suck up the cost of it and the use of "an attempt" that our insurance covers if we were able to test 5 or more blasts.

However I'm worried we will get to day 5 and only have 2-3 left. My idea is to prepare for a fresh transfer so if I only have 2-3 blasts I will just transfer them ( only best looking 2) and if I have more stop meds and do a biopsy amd freeze all.

I feel like this hedges all the bets. And at least I'll get a chance at a transfer .

What at meds are taken if you are doing a fresh transfer vs a freeze all. I'm guessing it's the Estrogren, endometrin, and PIO right or does that not start until after transfer?

prudence9-2 · March 2017

I think what you should do is come up with a number and only if you reach that number you go for PGS... Like you said, if you only have 2-3, maybe just do a fresh transfer...

When I was doing IVF my doctor wanted me to do PGS because of my age, but only if I have above a certain number.

I ended up doing the PGS but because I wasn't sure how many will make it, I did start the medication as if I was going for a fresh transfer. I was doing PIO shots from the day of the retrieval and if I remember correctly, I also took Estrogen pills.

Ash_SE · March 2017

Thank you. At least I know my plan isn't crazy.

rainbowwishes5 · March 2017

Well as I understand it if the embryos can't make it to blast outside of you, they probably won't be able to make it inside of you?? I thought that was the idea behind day 5/6 transfers? I'm no expert though. You need to do what you feel is best. If your gut tells you that is best- go for it.

JuliaGoolia719 · March 2017

We decided to do PGS to try and cut down the chances of miscarriage, (I know that nothing is 100% but having "normal" embryos cuts the chances at least). We were doing a freeze all anyway bc I was at high risk for OHSS so a fresh transfer wasn't going to happen anyway. It made the decision easier since we would be freezing them all anyway. We had 2 make it to day 5 and both came back normal.

I think its one of those decisions that only you guys can make for you, theres not a "right" or "wrong" decision in my opinion.

Ash_SE · March 2017

rainbowwishes5 said:

Well as I understand it if the embryos can't make it to blast outside of you, they probably won't be able to make it inside of you?? I thought that was the idea behind day 5/6 transfers? I'm no expert though. You need to do what you feel is best. If your gut tells you that is best- go for it.

If we only have 2 make it to day 5, I'm not spending 4K to test and freeze and thaw. I'm putting them in and giving it a chance. At 2 there isn't a "hope we pick a normal one from the group of multiple embryos". Also there is a lot of research that sometimes PGS testing isn't 100% accurate or a mosaic embryo could self heal.

prudence9-2 · March 2017

Ash_SE said:

rainbowwishes5 said:

Well as I understand it if the embryos can't make it to blast outside of you, they probably won't be able to make it inside of you?? I thought that was the idea behind day 5/6 transfers? I'm no expert though. You need to do what you feel is best. If your gut tells you that is best- go for it.

If we only have 2 make it to day 5, I'm not spending 4K to test and freeze and thaw. I'm putting them in and giving it a chance. At 2 there isn't a "hope we pick a normal one from the group of multiple embryos". Also there is a lot of research that sometimes PGS testing isn't 100% accurate or a mosaic embryo could self heal.

I totally agree....

**TW**
I transferred a PGS tested embryo and still had a m/c... I still haven't got the pathology report.... so I'm not sure if the embryo was normal or not... but nothing is 100%.

liljoy-2 · March 2017

PGS only tests for high level abnormalities, meaning the number of chromosomes. But small portions of the chromosomes can still be abnormal too (duplicated or missing) and NOT detected by PGS, that's why about 30% of PGS normal embryos miscarry or don't implant. At least that's what my clinic said. The genetic testing is still in its infancy.

FuzzyDust · March 2017

we decided to do PGS for the same reason @JuliaGoolia719 did. We had 3 embryos that made it to hatching blasts, and 2 of them came back normal. Our clinic seems to get a discount, as we only paid $200 per embryo ($600 for 3), so it didn't matter how many we'd have.

xomarisaxo · March 2017

In may of 2015 I had a MC with a natural pregnancy. I did a Fresh cycle September 2016....ended up with 3..froze 1 implanted 2. I was pregnant with one. Had a MC at 8 1/2 weeks . Turned out to be an abnormal embryo. It was a 5 day blastocyst so yea it's rare that abnormal embryos make it to day 5 and implant but mine did.

this time I did PGS testing. Did another round of IVF I only had one make it to 5 day. I tested that one and my frozen and they were both normal. Did a FET on March 8 and currently pregnant. I go on Tuesday to see how many took. It's expensive just to test 2 yes...but for me, worth it. I'm only 32 so I did t qualify for PGS but since I had 2 other MC I refused to implant unless I knew they were normal.

it's a hard decision but do what works for you!!

cmiller73 · March 2017

Popped in since DH and I are doing PGS on our IVF quest.

The 'prep for fresh, have option for frozen' is what ended up happening in my first cycle since initially I was not responding super well to the stims. My RE had me buy both triggers (HCG and Lupron) and was on the fence about a dual trigger (option to fresh transfer with HcG, Lupron to protect against OHSS) versus only Lupron as my E2 and my follicle count was getting up there.

It was nice having the option from my team. It ended up not mattering in the end (25 follies and E2 of almost 3500 so it was a Lupron only trigger for me to drop my estradiol level way down post ER) and we ended with one testable day 5 hatching blast, so it was right back into another ER cycle afterwards.

rainbowwishes5 · March 2017

Ash_SE said:

rainbowwishes5 said:

Well as I understand it if the embryos can't make it to blast outside of you, they probably won't be able to make it inside of you?? I thought that was the idea behind day 5/6 transfers? I'm no expert though. You need to do what you feel is best. If your gut tells you that is best- go for it.

If we only have 2 make it to day 5, I'm not spending 4K to test and freeze and thaw. I'm putting them in and giving it a chance. At 2 there isn't a "hope we pick a normal one from the group of multiple embryos". Also there is a lot of research that sometimes PGS testing isn't 100% accurate or a mosaic embryo could self heal.

I did this FET#1 in January. 1 if the 2 non tested day 5s implanted. Guess how it ended. So for IVF #2 I had them tested. My clinic kept saying that I had 4 embryos TW^**** cp because they weren't normal. So I wanted to that shut down if I have yet another MC. But if you just wanted reassurance to not PGS test you should have just stated that. Otherwise you will get honest opinions. But you need to do what you feel most comfortable with.

Ash_SE · March 2017

Not at all! I want honest opinions and experience. Thank you everyone!

herewegoagain3rd · March 2017

I am struggling with this decision. My DH and I have finally decided to go ahead with IVF (probably not until August-Sept time frame). The thing that held us back before was the cost and it still something that we are both very hesitant about. So the thought of adding on thousands more dollars is very scary. However, I am AMA, so that is another big consideration. I was very glad to read this thread to see other ladies experiences.

2MomsHoping · April 2017

We are doing PGS with our IVF. Three early miscarriages have taken their toll on me emotionally and honestly anything I could do to avoid that I will do. However, its so true that there are no guarantees and a PGS normal still has only a 60-70% pregnancy rate but I guess I want to do all I can do to avoid the rollercoaster of transfers that have a low chance of success. I don't want to go onto an IVF#3 so we are taking our 2 from our first cycle and whatever we get from IVF #2 and having them all tested before we do an FET. For our insurance caps we had to make the call between PGS and the the opportunity to do a IVF3.

As a couple we felt that emotionally PGS was the right choice for us.

rainbowwishes5 · April 2017

@2MomsHoping I'm in the same mc boat as you. Hugs.

Ash_SE · April 2017

im in the same boat loss wise too. We decided to go for PGS. We were paying for freeze anyway because we hoped to have more than 2 blasts and the biopsy for PGS is $2500 , the cost for the PGS is only $150 each embryo. At $3500 max we figure we can get some peace of mind and help in narrowing down my loss issues. It is a lot of money but I've cut down spending on other areas and probably not taking a huge vacation this year ( hopefully PG!).

I will ill say I was torn up by the decision but at this point so glad I made it. We are hoping and on track to get at least 5 blasts so that makes it worth it.

Hopeful_mom · April 2017

I've been torn with this decision since I had my MC. I had a fresh transfer and 2 stuck I was going strong for about 10wks, I was able to test one which was normal so i'm not sold that was the problem.
I don't produce a lot of eggs so to wait to test the few i get is hard and i'm OOP for it all. I just had my ER and was lucky enough to get 3 frosties i pray I get them back. I wanted to transfer them however OH was not having it. I lost a lot of blood during my MC and he doesn't want me going through that again. I keep reminding him that doing the testing doesn't put us all in the clear either so we shall see. Its such a hard decision and OH and I dont really agree on it. I'm tempted on this next cycle to try a fresh transfer and hopeful have extra frosties to test after...haven't gotten OH on board for that yet.

prudence9-2 · April 2017

@Hopeful_mom yeah, the decision for PGS is a tough one. And I think that for you it is tougher because your embryo came back normal. But with your age (and I'm older so for me the stats are even worse), the percentage of good embryos is much lower... But especially since I do OOP for most as well, I rather not waste time and money and on a bad embryo... (with that said, like you, I had it not work with a normal embryo as well...)

prudence9-2 · April 2017

@Ash_SE when will you get the PGS results? how many made it to blast?

rainbowwishes5 · April 2017

@Hopeful_mom I'm am also not sold at all my mcs were aneuploid related but my clinic keeps harping on about it so I wanted to shut them up and guess what? Of my 2 blasts both were normal so what do you think the chances at least 1 of the past 4 embryos were normal?? Statistically significant. Still they say "oh well we don't know what their karotypes were so...." BS. They keep blaming it on the embryos but I know that's BS. It's an easy scapegoat for them. Ugh.

Ash_SE · April 2017

So far I have 8 blasts with a possible 3 more they are watching until tomorrow. I'm so glad I decided on PGS and against fresh transfer as I want to know my embryos are normal before we try to tackle my implantation issues and Immune related issues. @prudence9 thanks for asking. It takes 7-10 days for the results. @rainbowwishes5 I totally hear you. The RE I'm seeing focuses on repeat loss specially on the immune system being outta sorts and causing them vs a bad embryo. I have several blood clotting issues and MTHFR that no other doctor had found either. When we do the FET (and in prep for the ER) I will be on Prednisone , Lovenox, pure Folate ( not folic acid) , and Intralipids infusion to suppress my immune system and address clotting. This is only my first hurdle to jump through. There is a FB specially for this with discussion and doctors that believe in it if you are interested. Reproductive Immunology.

prudence9-2 · April 2017

@Ash_SE wow!!!! That's amazing!!!! With how many eggs did you start that 8 (or maybe even 11) made it to blast?

As for the results, I have a feeling you'd get them sooner! When I did PGS (and we had to ship it from the west coast to a lab in the east coast) I got the results within 4 days...

rainbowwishes5 · April 2017

Ash_SE holy moly!!! I will likely not have 8 blasts after 4 rounds of ERs! I would beyond a doubt do PGS if I had a crazy amount of blasts like that! I didn't even have 8 eggs!!!!! Omg congrats

Ash_SE · April 2017

Yes after years of early losses and an ectopic pg I was holding not a lot of hope in this IVF . Granted it was my first and I'm 33 which helps but I was figuring it was an egg quality problem will my losses and I think my RE was too. PGS will help solve that mystery as they could still all be abnormal. I'm hoping for 5 normals. That is my line for not doing another ER right away. Due to my loss history I'm nervous about the FET unless we have multiple normals stocked up. I want to do a FET with 1 normal to complete the "attempt". If that doesn't take with my RE transfer protocol for multiple losses, we will pause and think of what to do. We are thinking 1 more ER and then try again with the frozen FET with a tweak to protocol and then consider saving for a Gestational carrier ( saving at least 4 normals for that).

We started with 13 eggs at ER, all were mature, all fertilized with ICSI ( we didn't want to take any chances and insurance covered it even though my OH doesn't have MFI) , 12/13 were at least 8 cells on day 3 and all 13/13 were Morolas ( different stages) on day 4. I'm hoping I pick up at least 1 blast more tomorrow morning.

prudence9-2 · April 2017

@Ash_SE those are amazing numbers!!! 8/13 made it to blast! (And maybe even more!) I think you have good chances of having 5 normal! FX!!!

Hopeful_mom · April 2017

Ash_SE so sorry for your losses! Were the MC conceived naturally? It sounds like you have a great plan going forward. AND Woah those are really impressive numbers! I've got everything crossed for you, you're going to get normals back! Great insurance picked up the cost, amazing how different insurances are in IVF land. good luck!

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