PGS - all abnormal

[Ajak]

Hi All - i am new to this but hopefully someone can help. We had PGS done and all 8 embryos came back abnormal. The clinics policy is to discard them. I was wondering whether anyone has experienced something similar? And if so, would you go ‘again’? My concern is that if they were all abnormal this time, the same will happen next time (despite the doctor stating that every menstrual cycle is different). 37 old.

@ginandtonicformeplease
We also looked into sperm fragmentation but clinic said treatment for it was pretty much the same as the male pre conception vitamins which DH has taken for best part of 18 months anyway

We are also going ICSI

Wow! This is helpful. I had 21 eggs, 12 fertilized, 8 survived biopsy and all were abnormal. Probably the biggest gut punch I have ever had... and I have lost 6 pregnancies. I was horrified. Utter disbelief. Most if not all of my losses (after my perfect daughter) were ectopic as we later found out so I was dumbstruck that my infertility may also be complicated by genetics. And 7 of them were just a horrid assortment of genetic problems. But 1 was considered a mosaic. That meant it "may" work because the results were inconclusive.

I called the lab that did the testing and spoke to the director who explained to me the process. As someone who does laboratory work for a living I was blown away. No oversight, no accrediting agencies, one lab could get entirely different results than another lab. Each lab has its own secret methods. Basically what they do is take X number of cells (which they do not know) and mix them all up and get a percentage of how many defects to non-defective genes there are for each chromosome.

There is a lot of guess-work going on. Mostly because embryo testing is so taboo there is little good science behind what is the most effective way to screen for genetic defects! The do NOT karyotype each cell as I had thought, just test the entire cell cluster taken from each embryo in one mass. This does not sit well with me. My reasoning:

1. A percentage has more impact if you know the X variable. 50% errors means two different things if you have 2 cells vs. 10 cells.

1. Where these cells are sampled from may (because we lack good science on the subject) make a difference. The sampled section may be a group of "bad" cells instead of a group of "good" ones. There is evidence that "bad" cells may be pushed out of the innermass to be used for placental tissue instead of fetal tissues.

These are my main issues with the process. I contacted many people trying to gather some good info on this subject. Many old professors and the like. I needed to make sense of it - because it didnt make any sense to me! I didnt believe it!

My IVF doctor was not interested. And I felt for the first time that I was just a paycheck to him. "You can do it again and start over if you would like." Of corse. And can I also finance your new boat as well?

I keep hearing so many simmilar issues with the PGS and thought Id share my story.

Ironically, I was set to transfer my 1 iffy embryo but kept getting delayed. I did the expensive uterine lining test and found I needed 48 hours extra on progesterone before transfer. We tried for 4 cycles to implant and my estrogen shots were making me absolutely nuts! So I took a month off. I got pregnant. Naturally. I had already lost 1 tube and my other was thought to have been severely damaged in a prior ectopic I survived. I was given an infertile diagnosis but wanted to wait until after IVF to snip the remaining tube. My egg traveled from my R ovary to my mangled L tube and got it somehow! And I am 10w pregnant!

All my embryos are stored. At great cost. And they will remain so until I am at peace with it all. They are all my babies.

In the US only SOME clinics will transfer non-viable abnormals. There are two types of "abnormal" being non-viable and the other a "mosaic" or an inconclusive. Most clinics will transfer a mosaic.

The reasoning behind not transfering non-viables are sucess numbers. Clinics have to record their sucess rates. They do not want to transfer embryos that are not likely to survive, this drops their sucess rates and makes them seem less desireable to new customers. It is a business.

I looked into transfering my non-viables but decided after the cost of transfering the embryos across the country and starting over somewhere else, taking off work to travel there, stay housed there etc. it made more sense financially to just start over. And hope for a better outcome.

Alsowas told we could try coQ10 or other supplements... which why the heck wasnt I told about that when I paid a ton of money in the first place! Please! Was just floored when I was given that advise for a second round.

How's everyone getting on. I'll be doing another EC next week and I'm terrified they'll all be abnormal again.

@Ajak I hope you're well. Can I ask what you decided after you started this thread? I've just had all 4 embryos come back as abnormal, and I'm not feeling that confident about another round, so wondered what your experience was? Thanks!

I’m about to embark on pgs , like one of the other posters I’ve been through multiple mcs and they are very difficult. Especially after seeing heartbeats on scans and movement . I’m going into ivf and a lot of cost and will probably get all abnormal but I can’t do a transfer of a known chromosomal abnormality. If you know it’s got a trisomy or something , I think that knowledge is powerful. My clinic do put back low level mosaics so if I got that I’d have discussions as they can rectify themselves, but I wouldn’t blindly put back embryos after experiencing mmc x

I PGS tested on my second IVF cycle after having 5 miscarriages. All abnormal except one low level mosaic which was allowed to transfer but was a BFN. I decided not to test anymore but changed my protocol to natural modified IVF to focus on much fewer follicles (2 instead of 14) - I got 2 follicles and 2 blastocysts on the next cycle and both stuck and I'm pregnant with twins. I'm very sceptical of PGS now x

@ivfbeenbusy do you think that’s because natural /mild ivf focuses on less eggs but higher quality ? Why was this suggested to you ? I might look at that option too x

And congratulations on twins ! How lovely x

I absolutely think it's because we focused on quality over quantity. The rounds where I did PGS testing was normal IVF - over 2 cycles and a total of 28 eggs less than 30% fertilised even with ICSI and 4 average quality blastocysts.
Compared to natural modified IVF over 2 cycles 9 eggs 100% fertilised and 4 top quality blastocysts (2 are my twins and I have 2 more frozen)

It definitely wasn't a change in supplements that made a difference as I've been on the same for all 5 cycles - that includes the ones lauded about in "it starts with an egg" like ubquinol/coq10 etc and it wasn't healthy lifestyle/eating etc because my twins were from an egg collection straight after Xmas after weeks of drinking and eating rubbish

Thanks so much for this , my clinic never even mentioned this although they do do it ?? My mcs are likely because of age/chromosome issues as all other tests were clear - so quality is key for me . Thanks - I’ll get some more info ! X

@ivfbeenbusy sorry rechecked my clinic and they do natural ivf which I think is different to natural modified ivf ?? Where did you have your natural modified cycle? X

I was with Create x

Thanks for your help hun x

Hello me again, been reading and says mild ivf is for those with normal or good ovarian reserve , is that what you had @ivfbeenbusy? Mine is low reserve so that might count me out x

Hi @Sunshinelove8 I'm also doing embryo testing due to having had 2 MMC's in the past, and really not being able to face that again. Plus I turned 39 today, and it takes so many months to recover and start trying after a MMC, so I don't feel I have the time to wait!
I actually did 'gentle' IVF first. That's when I had the 2 MMC's, and so I later tested the 3 remaining embryos, and they were all abnormal. That's when I moved to a different clinic and did more usual IVF, where they're pushing for the number of eggs, but once again all 4 embryos were abnormal. My Dr said that as long as you're not pushing for more than about 30 eggs, it shouldn't affect quality, and that as you get older, like I am, it's more a game of numbers, hence trying to have more eggs to play with! He thinks it's just bad luck that we had all abnormals. Wishing you lots of luck with your next round!

@Ivfstory are you doing ivf then or medicated natural ivf? I do agree it’s a numbers game . It’s just cost . Ivf is not cheap and also the toll it takes with meds etc . So how many tries are realistic ? For us it’s probably just a couple tries x

Sorry reread and it seems you’re doing ivf proper x

We got ours tested and all were abnormal -1 didn’t even survive defrost. I think all of them were, before we did the testing we transferred 2 embryos in one go but they failed. They said ours ages (38 and 36 at the time) but that feels a little lazy to me. Current waiting for a sperm DNA fragmentation test as a fair few of our embryos didn’t make it past day 3, which often indicates sperm issues

That’s what I worry about - they’ll all be abnormal. Did you get any with mosacism?

@Sunshinelove8 no mosaicism ones

Do you know what your amh and fsh are sometimes it gives an indication of egg quality . It’s so hard to go through it all and get none to transfer . What made you try pgs ? X

@Sunshinelove8 AMH is 25.2 and FSH was 8. We did get 2 to transfer, we did a double transfer but it failed. Couldn’t face more wasted money on transfers / feeling ill and disappointment in a nutshell

Yeah I need to do pgs as although I get pregnant every few months they always end in a mmc , so want to ensure embryo is not abnormal. I hear a lot of tales of getting pgs all abnormal though :/ what will you do if sperm is ok ? Do another round with pgs ? X

@Sunshinelove8 probably not more IVF with PGS. Might consider donor sperm or eggs. Or just do nothing