PGS Testing?

[Peanut1980]

Hi,

So I’m 39. Have one DS 6 years old natural conception with ease. We’ve had a fresh cycle of IVF for which we had a missed miscarriage. We’ve just had a frozen FET cycle. Currently unexplained fertility. We’re looking into PGS testing for next cycle. Anyone have any views or experience of PGS testing?

Thank you xxx

I have secondary infertility and 4 miscarriages and 1 failed FET in the last 2 years - I also asked my ivf clinic about PGS after a naturally conceived miscarriage last month. Their opinion is that the test it's still in its infancy and maybe only 60-70% accurate at testing for abnormalities as they only remove a tiny portion of the cells and they could miss the good (or bad) cells in another area - giving false results. They're has also been an interesting American study in which older women who only had PGS abnormal embryos left after several failed cycles with normal ones - these women agreed to try transferring the abnormal ones and a significant number actually went on to gave healthy normal babies. So there is evidence that actually early blastocysts can actually "correct" themselves

Also I know loads if people who have still had failed cycles or gone on to miscarry PGS normal blastocysts - it's expensive (£3k) so we've decided not to do it

That’s very interesting thank you. I read amazing things about the testing but then I read an article recently that said the abnormal cells could correct themselves and my fear would be we could potentially write of a whole cycle where it may still have a chance. Eurgh this is so hard!!! I just want answers 🤦‍♀️ I want to know why we’re not having any luck and if there’s anything else we can do to help our chances x

@Peanut1980 we had 2 blasts from our last IVF/ICSI in March, AB grade respectively. 1 was PGS tested and 1 was transferred without. I had BFP, early scan at 7w3d showed a strong heartbeat and 9 week scan showed no heartbeat anymore. Missed miscarriage. At the same time we got PGS results about the frozen embryo. Sadly it had trisomy in 18 which is a very bad news and consequently not viable for transfer. And I only suspect the other embryo had some chromosomal abnormalities. I had a surgical procedure to remove pregnancy after MMC and asked to send a tissue for testing. Still waiting for results. In March I was 42.

Oh @russkispy I’m so sorry to hear that. I hope you’ve now recovered physically. I know the mental/emotional side takes longer. Do you mind me asking what your next steps will be? Would those results affect all future cycles too? D xxx

@Peanut1980 thank you! That was our 2nd IVF/ICSI. The first failed and I didn't have any backup. And I never tested the only embryo then. And this round showed those results. We're more likely to go for DE now. All my treatments were done back at home (abroad). And DE would be done there too and more likely July/August. My doctor thinks I'd have poor prognoses again if we tried with our own eggs and chances are slim. DE gives more success chances at my age. Something to seriously to consider. And you? Ps I have a DD from IUI and she's almost 2.

I considered PGS testing after 3 failed cycles and the consultant took a really practical view and said the decision as to whether to PGS-test should also depend on how many embryos you end up with during a cycle.

If you have lots - more than four great quality blasts at day 5, for example, it makes sense to test them and only transfer any normal ones found.

I only ever had one or two embryos, so was advised to just transfer them and see what happens.

@ruskispy good luck with your DE. It’s not really an option for us. I don’t know why. We both just decided that if we couldn’t have another with our own sperm/egg then we would leave it.

That’s interesting @redpandafluff. I only had two embryos make it to day 5. I have a meeting with our consultant on Tuesday of next week to discuss a plan for our 2nd and probably final cycle. I’m just trying to do some ground work before then xxx

I had PGS of 6 blastocysts last December. My rationale was recurrent miscarriages (5 of them) but also some successful pregnancies. My clinic uses day 5/6 NGS which is a very different procedure to the day 3 testing - takes about 8 cells from the part of the embryo that will become the placenta.

Ahead of time, we discussed the kind of blastocysts we would be happy to transfer: euploid, and mosaic, would have been fine with us. Complex aneuploid would not. The embryologist advised us in detail about the types of mosaicism that were associated with good outcomes, and those with less good outcomes, based on the current research literature.

We ended up with 4 euploid embryos and 2 with minor mosaicism. We knew transferring a euploid embryo was not a guarantee because there's lots of other aspects of the embryo that affect implantation and/or miscarriage, such as mitochondria and aspects of embryo structure. However, we transferred a day 5 euploid 5aa blast in February and I am now 19 weeks pregnant (fingers tightly crossed).

@bottomleypottsspots2 thank so much for sharing and congratulations. Wishing you a happy and healthy pregnancy. I have so much to learn about the different types of embryos!

I ended up with 3 perfect euploid embryos after PGS, am awaiting my third transfer after the first two failed inexplicably. I think it’s a good idea if you get a high number of embryos and you don’t want to transfer more than 1 at a time. However if I had my time again I would probably save the £3k and spend it on an ERA test instead to make sure we were transferring at the right time.

@cancancanyoudothe I haven’t even heard of an era test. I’ll have to ask about this next week. I’m so sorry to hear your transfers haven’t been successful to date. It’s so soul destroying. It consumes so much of my thoughts throughout the day, every day. I just want to have a frank discussion with the consultant next week to see whether he thinks we have a chance. We paid for two cycles and don’t think we’ll keep throwing money at it. Maybe we’ll just go ahead with the next cycle as normal. Just have to hope we get some embryos to start with x

We had a large number of embryos - over 15. We had one transferred - top quality - and a miscarriage (blighted ovum) at six weeks pregnant. Had another one transferred six months later - also top quality - and another BO at six weeks. Clinic recommended PGS testing because of the identical nature of the MCs. We got the remaining embryos PGS tested. Five came back as normal, one inconclusive and the rest were abnormal. We transferred one normal one and had DC1 nine months later. We then transferred another normal one nearly two years after that and had DC2.

@user1471592953 that’s really interesting. Thanks for sharing. I met with my consultant today and he doesn’t think we should do PGS testing just yet. If we had a large number of embryos then we might consider it. He did tell me that if we did have them tested then they’d use the normal ones first and we could use the abnormal embryos after. I was worried they’d all be discarded if abnormal. He did say that you can get a false negative and a false positive. So many options for different tests but not a lot of stats behind them to confirm whether valuable or not.

I think we’re just going to try the same long protocol but increase drugs to produce more eggs 🤞🤞🤞🤞🤞🤞🤞🤞 I did ask him whether there’s any point in continuing and he absolutely thinks we should. Of course there’s no guarantees. They think it might be my egg quality for which we can’t do much about xxx

just heard from our hospital that our transferred embryo didn’t have any abnormalities! We will get full report in the next couple of days but the good news is that it didn’t have any chromosomal abnormalities! My only frozen embryo from 2nd round was PGS tested and had trisomy in 18. Of course my main question is why miscarriage happened? And last year too! (From IUI) we've been considering DE and Naturally I’m worried if I’ll miscarry with donor egg?! And now I’m thinking shall we try IVF with our own eggs again? Have a bigger dose from the start? And try different meds?! (Always had short protocol) And somehow support my system against miscarriages?! I’m now more confused than ever! And upset as my own embryo was ok and yet I miscarried. What would you do?!

Hiya @russkispy. That’s useful to know but it always creates more questions. We’ve decided not to do PGS testing. The plan of action for our next cycle is to increase the stims to produce more eggs plus I’ll be taking steroids, aspirin and some other blood thinning injection. 🤞🤞🤞 That’s to help with any blood clotting or immune issues.

Fingers crossed and good luck to you in your cycle x

Hi - I had day 5 PGS (NGS) as had a very large number of blastocysts (24!) and needed to know which were normal - I ended up with 11 normal so could have been lots of heartbreak if I hadn’t tested. We transferred one of the normals via FET which resulted in my DS. I then had DD naturally.

I don’t think I would test if I had less than 3 blastocysts, but would if I had more than that. Also, are you in the uk? I was under the impression that abnormal embryos couldn’t be preserved (ie they are obliged to destroy aneuploid embies) but may have the wrong end of the stick there.

Also there are plenty of people who still miscarry with a normal PGS embie. It’s definitely not a guarantee!

I have 3 embryos left and will be testing them since I've had 2 miscarriages. The doctor said about half are usually normal/abnormal so I'm hoping I've already transferred the abnormal ones and the remaining are ok, but we'll see.

Yes I agree it makes sense when you have so many to work with. I only had 2 that made it to day 5. In the UK they allow you to use the abnormal ones but you usually prioritise the normal ahead of these. There’s still a chance that the abnormal could progress into healthy babies so luckily we still have the option xx