PGS Testing... necessary?

1berettam · December 2019

Hi Everyone,

My doctor needs to know ASAP if we will be opting for PGS testing or not.
Originally, because of our age (me 31, DH 34) and our results from our own genetic testing, our doctor said it was not necessary, but now I am second guessing this decision.

A part of me really wants to try for a fresh transfer and PGS testing is EXTREMELY expensive... the other part of me wants reassurance that my possibility of implanting a healthy embryo is pretty high.

What are your thoughts/opinions?
Thanks!

ladyp0tter · December 2019

Well, I will give you my recent 2cents story. I started IVF at 43 because I got remarried 4 years ago and previously had my tubes tied after my ex and I had our last child. I had previous miscarriages with him. 2 losses in 2002, then had my 1st daughter 2003, 2 more losses 2005, 2009, then my twins naturally 2010. All without IVF. My only issue that was discovered then was a blood clotting disorder (typically solved with baby asprin for me).

NOW...at 43, I knew the risk of bad eggs at this stage. So we decided to do PGS with our first round of IVF. Retrieved 24 eggs (which was a HUGE surprise to ME AND my RE). ended up with 7- 6 day blasts of which NONE were normal (well, technically I had 6 abnormal and 1 indeterminate). After discussing with the Genetic counselor, we agreed to transfer the indeterminate in hopes it was normal and one of the abnormal ones in hopes that the result was wrong or at minimal, not a life-threatening issue. BFN.

The second round just done 2 weeks ago, I did a lot of research and asked my doctor to lower my med protocol to avoid a higher LH surge (which can affect egg quality). I had also been taking a bunch of supplements for now 4 months which SHOULD have improved the quality. They also added HGH. We decided THIS round, that we would go straight for a fresh (with 1 or 2 depending on how many embryos were still growing) AND PGS/Freeze the remainder. This way, we would get two shots potentially at a baby.

Now....I am 12dp5dt of two fresh early 5 day blasts (he said if we had not been doing the fresh, he would have let them both grow one more day). I have been getting faint BFP tests since 8dp5dt (which is later than most people get their first +'s). I had my first HCG draw this morning and I am at 11.93.....UGH. Likely this means one of two things....another bad egg, but somehow it implanted and is trying to grow or I implanted late and will be fine. Won't know for sure until Wed or Friday (Wed if my numbers either go down or not up enough). In this round, I had 1 extra that made it to freeze that is being tested (I should know by the end of this week if it is normal or not). If it is, we will schedule the next FET.

All that to say, in my opinion, it is a matter of what your heart can take. However many eggs you get to make it to day 3 or 5 (depending on how you decide to go)....are you willing to risk repeated miscarriages of bad eggs like I may be going through right now....or avoid the heartache and have a better idea of IF they will work (since sometimes even the good eggs don't work). If you are willing to risk it, then don't test. For me, each transfer costs like $4-$5K so I wanted to have a better idea of if it might work.

I am skeptical about the results of PGS 100%, but I am willing to bet that if you get a normal....you will be way more likely to have a more successful outcome than just putting one in after another without knowing. I know there has been stories of those people with abnormal's turning out fine, but technically, that is more for mosaic embryo's which are supposed to have the ability to go either way.

From what I learned from my RE and the counselor....different labs categorize the embryo's at different levels for mosaicism. Meaning one may say 10% or less is mosaic, another may say 20% or less abnormal is mosaic. You would have a better chance of a 10% abnormal being normal than a 20% if you go by odds.

So in the end....what does your heart say. can you take the repeated transfers of unknowns or are you willing to risk it? That's what it came down to. First-round for me, I wasn't willing to risk it until I had 0!! The second round, I was more willing to risk it and do the fresh transfer and although it worked (I got PG)....I am not sure if it is a good egg yet or not.

cashewchicken · December 2019

If your doctor said it’s unnecessary, it probably is. I had my embryos tested, but I am AMA (38 at the time of retrieval, now 41), had polycystic ovaries (PCO) so I produce more eggs than average, and I wanted to bank embryos for future pregnancy. I knew that based on my age, less than half of my embryos will be normal, and with many eggs retrieved due to PCO, I needed a way to weed out the bad ones. I also wanted 2 babies (and not twins) and needed enough embryos frozen and stored to guarantee that.

sarahroses · December 2019

At your age, I'd say don't do it. PGS is not a perfected science so far (read the thread on PGS on this forum).

31magnolia · December 2019

Even at my age (43), I'm not doing it. I've only been producing 1-2 eggs (resulting in 1 embryo) and knowing that the test isn't an exact science and there can be some damage to the embryo from the test (although I think it's rare) is what caused me to say no. I figure if I'm able to get pregnant naturally, I wouldn't know anything until week 8-12 weeks, anyway. In the end I may be adding more emotional stress to my plate but PGS testing isn't 100% accurate.

31magnolia · December 2019

Also, wanted to add that there are plenty of women on this board who transfer a "normal" PGS embryo and it still doesn't implant. But you definitely have to do what you'll feel comfortable with.

mbradfo2 · December 2019

Under 35, my doctor didn't recommend PGS unless there was some strong reason to do it (known genetic issue, recurrent losses, etc). We decided at the beginning of our cycle not to do it based on my doctor's recommendation and we only got two embryos anyway so it wouldn't have made a difference. I think PGS has some benefit if you have some reason to do it or are looking for a way to decide which embryos to try first (if you have a lot of embryos to choose from).

PGS Norm isn't a guarantee either -- it increases chance of success but you can still get m/c or BFN's (I have friends and acquaintances in both situations with PGS normies).

It's also, as was said, a very new science and far from perfect. Clinics are beginning to use some abnormal embryos selectively and healthy babies are being born from them. The reasoning behind this is that PGS only tests a few cells in a multi-cell embryo. Sometimes those cells are ones that are destined to become placenta and their genetic make-up is not vital to the fetus. Sometimes those cells self-correct in development and end up becoming part of a healthy baby. Sometimes those cells are simply discarded or destroyed during natural growth. It's still a personal decision to make, I think, but research goes both ways.

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