PGD/PGS pros and cons

knottie9c27e57a67c3fe70 · September 2018

Hi everyone. I was wondering what everyone thought about PGD/PGS testing after IVF. I plan to do an IVF cycle this month and was considering PGD/PGS before transfer. I have prior health issues, lyme disease, fibromyalgia and chronic fatigue which im concerned all could have affected my eggs so thats why I wanted to do the testing but I am reading it can decrease pregnancy rates. Just wondering if anyone had any experience with it, thanks.

zamoraspin · September 2018

Hi, knottie. You might consider changing your username because it's hard to tag you with this one.
First up let's make sure we understand the uses of PGD and PGS, they are somewhat different. Whether to do PGD is a decision usually guided by your dr if you or your partner has a genetic condition that can be passed on -- a probe is developed to screen for that specific genetic condition so that embryos without that condition can be selected. PGS is a more general screening technique that is used to determine whether or not an embryo has 46 chromosomes or not.

PGS is generally recommended for - women who have experienced recurrent pregnancy loss, women who are over 35/have suspected egg quality issues, women who have a lot of embryos to "choose" from and therefore need a prioritization tool. I'm not sure where you read that pregnancy rates are lower with PGS - pregnancy rates and live birth rates are higher where a PGS normal embryo is transferred. Some couples do have trouble getting a PGS normal embryo though, so there is that, and also the biopsy is generally done on a day 5/6/7 blast so couples who have difficulty getting embryos go grow that long in a lab may also have a hurdle trying to get a PGS normal embryo. Ultimately PGS is a very personal decision. It's a science that has helped a lot of people but is also still in its infancy.

PGD is, again, recommended where one or both partners have a genetic condition.

Good luck.

anared · September 2018

Hi! I am in the middle of my first IVF cycle and I had my 3 (Day 5) embryos PGS tested. I ended up with one normal and two low level mosaic. At this time, my clinic does not transfer mosaic embryos, so really I only have one. The genetics lab gave us a post counseling session, and we learned a lot about the two mosaic embryos. And sure, there is a possibility that the mosaic embryos can self correct once implanted and end up with a normal baby, however, if it doesn't I would be faced with considerable heartbreak. Personally, I am happy I went with PGS testing.

I am not sure it decreases pregnancy rates, because implanting a normal embryo increases the probability of having a live birth. However, it can decrease your options since once the status of an embryo is known, many clinics will not take the chance and implant anything that is not deemed normal. So in that regard you have less to work with.

As @zamora_spin had mentioned, PGD is only offered to those with pre-existing genetic conditions. Talk to your RE and weigh the pros and cons of both- as well as find out their policies for transfer. Choose what is right for you.

Holls214 · September 2018

We did PGS testing and I’m happy we did. I figured we were already spending a ton why not also test them? For me it was an extra piece of mind knowing we weren’t going to transfer an embryo that might have a higher risk of no implanting or being abnormal. I’m 33 (I was 32 at the time of my egg retrieval) so the doctors said it was really up to me if we opted for it or not.

Tulips29 · September 2018

I had a similar situation as @anared. We had 3 embryos that we sent off for testing. One came back excellent quality, one poor and one undetermined. So I only had 1 embryo to transfer when it came time to do so. I'm happy we chose to test the embryos as it gives you a higher probability of success. The undetermined embryo eventually came back as normal and was rated as OK but not excellent. It didn't implant when we transferred it in January and it might be because of the quality. My doctor also told me that if embryos aren't tested and then poor quality ones are implanted, it can result in a miscarriage, so testing embryos would also minimize those chances. I'm planning to test any future embryos again during the next ER cycle.

embryoman · September 2018

@knottie9c27e57a67c3fe70 Hi! PGS can be helpful for older (>35) women who start to show signs of decreasing egg quality. Also for those who have recurrent losses after transfering embryos it is helpful to know which to transfer. Abnormal embryos are the leading cause of miscarriage and by transferring euploid (normal) embryos you'll have a higher chance of implantation and therefore pregnancy. You should speak to your doctor to see their opinion on whether or not those prior issues have an effect on egg quality. Good luck!

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