Anyone had a "good egg" in a batch of bad ones (PGT-A)

[Burntparsnips]

2 weeks ago I had my egg collection and 5 eggs reached blastocyst stage
We transferred 2 on the 5th day (one average, one poor)
We tested 2 genetically
We froze one without testing

Today I found out I was pregnant and we were so excited as we’ve had many many years / rounds of IVF. It was our little Christmas miracle!

Unfortunately the embryologist has since called to say the 2 embryos that were tested are abnormal (one chromosome issues, one had no DNA found). She said she couldn’t comment on the other embryos as they weren't tested but that I should "definitely consider tests on the current positive" (her words).

Apparently I can speak to the geneticist but it will be in the new year as they have finished for Christmas

I truly thought this was a Christmas gift but the clinic have really managed to put a dampener on it. I really wish they had waited till after Christmas to give me the news or allow me one day of positive happiness

Has anyone ever had a similar experience and had a “good egg” in a batch of bad ones?

Thank you for the greeting 😅
Good luck with with yours, I do hope we have an answer by the end of this week.. I have to wait till my next cycle anyway as I came on at day 21 after EC so I’m all over the place now as I’m usually 33 days.. good luck to you

Happy birthday @IVFat43 I hope you get the perfect birthday present and hear that at least a few are fine (it only takes one after all)

I know it’s hard not to worry, it seems every stage of the IVF process means something to worry about (and more costs!!)

TBH I would have probably had the third tested but it wasn’t at the right stage at the time.
I personally wanted to try 2 fresh as a previous fresh round worked for us with but understand at our age the risks mean genetic testing beforehand has its benefits.

I wish you and @IslandStars every success, let us know how you get on

Thank you @Burntparsnips, wouldn’t that be a great present!
Keep us posted on your journey x

Morning ladies @IVFat43 @Burntparsnips, hope you're getting on ok.

Finally got my PGS results, 2 out of 13 normal. Relieved and happy i can move forward with FET, but with such a high number of blasts, i was secretly hoping for 3 normal in the hope that would be enough to stop me needing another round at some point. People have had far worse results, so i just have to pray one of these two were meant to be, i'm grateful to be in with a good chance, i just really need them to survive the thaw, as no back ups after these.

@IslandStars wow I’m surprised 2 out of 13, this is reason why I had mine tested, can you imagine implanting all those 13 over time, the cost involved, the expense each time and not forgetting the delay and emotional rollercoaster.

Although you have 2, I’d be happy with that. But we’re of the opinion we were only doing this once so if I get 2 I’ll have a back up for one more try as they’ll only ever implant 1.. however the more time that passes I’ve now started preparing myself I may have none, from 5 blastocysts 😩 and even when I think back I had 9 grade 1 perfect embryos and 4 very good..
It really is the luck of the draw unfortunately

Congratulations though, I’m chuffed for you, we may be at ET around the same time (fingers crossed 🤞) xx

@IVFat43 Thank you, hope we can both ET soon!

It really does show the benefit of testing, the consultant said to me that i have saved so much time, money and heartache, so even if PGS results are a bit low on the face of it, i just have to trust that it has done the job it was intended for.

My normals were 6BB and 6CA. I did have a coveted 5AA, but that was abnormal, so don't worry too much about gradings. Hope you get results soon x

I didn’t get my final grades, I’ve emailed them to ask but also chase the results.. it’ll be 2wks I had 3 tested Saturday and 2 Sunday..

Have they indicated when your ET will be? Are you also only allowed 1? I’m having a scratch but need to wait until my next day 1 to start a new protocol which will be conducted upon PGT results to determine when that’s necessary..

Hi @IslandStars. I'm really interested in what you say about the benefits of testing. I've done testing too, and expect to have a transfer next month with a PGS normal embryo.

I've been thinking a lot recently about how out of touch it feels that the HFEA classify PGS as "red" on their traffic light system. I totally get that it wouldn't be the preferred approach for every woman undergoing IVF in every scenario, and I also get the logic of why it's "red" - ie it doesn't work in the same way as other add ons in that it's basically a filtering mechanism for the embryos you already have. However, some of the most gruelling things about IVF are the uncertainty and waiting, which are two things that PGS can help with. It frustrates me that the HFEA's classification system has no way ascribing value to this - I bet many people (and I reckon some health professionals) probably just see the red score and think "dodgy".

@msgloria I’d seen this explained really well by a mumsnet user who said there are two schools of thought:

1. That we should only prioritize add ons that increased the chance of success, this is what the HFEA ascribe to.
2. That we should also prioritize add ons that reduce the length of time to pregnancy and reduce the number of cycles a woman goes through. When this isn’t prioritised women are put through a trial and error approach.

I had an unsuccessful fresh cycle and an unsuccessful frozen cycle, I had 7 embryos remaining, so I chose to PGT-A them before moving forward. I got the call on Tuesday to tell me 6 of them survived the thaw, I asked which one didn’t and I was told the best one hadn’t, a hatching 1,1 10/10, I was shocked. I’m trying to tell myself that this would have happened on the day of transfer if it hadn’t happened now, but choosing to do this put it through an additional risk. Now I will have a concern that embryos won’t survive the thaw and I’m putting my frozen embryos through an additional thaw and refreeze. The next consideration is damaging the embryos and finally uncertainty if they come back as mosaic.

I listenEd to an egg whisperer podcast where the expert being interviewed said if your under 40 with more than 5 embryos then do it. If you’re over 40 with 1 embryo then there is no point.

I now have to wait for the results to come back but I’m concerned about implantation failure, at least I will hopefully know I’m putting back an embryo that is euploid.

Thanks @Gardenlady543 that's a really thoughtful response. I'm really sorry your best quality embryo didn't survive the thaw. I hope the PGS helps you move forward, but appreciate your worry about further uncertainties.

I do wonder if there are some people who reach the point where they can't deal with the disappointment, cost and trauma of failed transfers and therefore stop treatment, when if they'd done PGS they might have carried on and had success. Which would meet the HFEA's first criteria, but is hard to measure.

I only have one usable embryo out of six across two cycles (doing PGD as well as PGS), so I'm trying to maximise the chances that it will stick. I've done an ERA (don't think ERAs have made it into the HFEA's traffic lights), but obviously it's still very stressful and it kind of feels like it will be even worse now if it doesn't work given I know it's a "good" embryo and my lining is receptive etc. I find it hard that I can't control the outcome by just "trying a bit harder" or "paying for one more thing".

@msgloria I completely agree with you, I chose to do this because after 2 unsuccessful cycles I need to put myself in a situation which has a chance of working. This is costing me a lot as I’m with access fertility so it would be cheaper to go with trial and error, but at what cost on an emotional level.

I have no idea what the results will be, I’m 35 so statistically I would hope for 50% euploid, but there is so much variation, so you can never know. I’m also looking at other factors, I’m worried about implantation failure so considering an ERA and scratch.

In the USA they do PGT-A testing a lot more, I think the results I get will help me decide whether I would do PGT-A testing again in the future. One thing that put me off was having to wait until the results are back before having any discussions about treatment, weeks can mean a lot in this journey.

Yes @Gardenlady543 I get where you're coming from. The way I've discussed it with doctors before is that if you had 100 embryos you'd expect roughly 50 to be euploid. But you're never going to have 100, and so the much smaller numbers can skew the results.

It's frustrating as out of six embryos you'd expect three, ie 50%, to be PGD normal. I only got two PGD normals (and only one of those is euploid), which feels really unfair but obviously it's just how the roll of the dice works when you don't have lots to play with.

Totally @msgloria I’m in two minds right now, I obviously want them all to be euploid but also I kind of want a reason to latch onto for why I’ve not been successful so far. I guess all I can do is wait now. It was false reassurance having 9 to begin with, who knows all 9 could be abnormal and with 1 transfer at a time, that’s a lot of heartache.

@msgloriaI I do think it's unfair and misleading for HEFA to red light it, because it confuses people over its intention. We know that PGS itself cannot create more live births, purely because it's not a treatment as such, it's a selection tool.

I think if you're over 40 or have suffered recurrent miscarriage and have a good number of embryos, then it's worthwhile. At 42, i could have wasted over a year transferring abnormal embryos because on the face of it, everyone was telling me how great i was responding and over achieving in terms of odds for my age, but it all means nothing if they will not implant.

I don't trust PGS 100%, perhaps one of my lost embryos should have been normal, or the mosaic declared normal, but that's the risk i've had to take when i had so many blasts.

I think in America it's viewed more positively because so many women choose it, even those in their 20s, so they don't see it as an add on.

Really hope your transfer is successful, it takes a lot to go through an extra stage of testing and worry.

Aaah thanks @IslandStars. My clinic is doing PGD for me (on the NHS) and they do PGS at the same time. I don't know that I could have opted out of the PGS even if I'd wanted to. I think overall I'm relieved to have done them both. I didn't ask what the nature of my other PGD normal aneuploid's chromosome issue was as I don't want to think about it too much, but I've found the embryologists to be excellent so far and I trust that it must have conclusively not been suitable for transfer. Just keeping everything crossed that with the ERA plus the PGS status that it will work - but there's still obviously around a 35% chance that it won't, which is a bit heartbreaking.

@Gardenlady543 have you had your PGT results?

Mine came back yesterday, unfortunately 3/5 abnormal and 2/5 inconclusive 😩

@IVFat43 mine aren’t back yet, they said they’d be back today at the earliest but that it could be another 1-2 weeks from now.

What do they mean by inconclusive? Is it mosaic or could they not get any results?. I think I remember you aiming for one in four in the past. It’s really annoying that they haven’t been able to specify euploid but I think it’s good that you are able to eliminate 3, they wouldn’t have worked and would have resulted in an unsuccessful transfer. Can you get an ERA done so they know your progesterone window and then arrange for a double transfer with the 2 inconclusive ones?

@Gardenlady543 the statement I was told “apparently it happens unfortunately when either they haven’t taken enough cells or can be damage on biopsy”.. they said they could thaw, retest & refreeze but then there’s another risk which can reduce the quality which I’m not party to doing. So like you suggest, we have a consultation Monday to discuss the next option; I want them both back in and hope for the best. They’re both 2-2 and I’m informed “okay”.. but could still end up either not surviving thaw, not implanting, end in miscarry or have health concerns which is worrying but I’m glad to at least be in a position to try..

The waiting is so frustrating isn’t it.. I really do sympathise it’s not easy! It feels like being in limbo doesn’t it 😢

@IVFat43 I think that’s a good plan, if I was in your situation I would push for the double transfer. There have definitely been positives from this situation, you have eliminated the need to go through 3 unsuccessful transfers, which is great- that would have had a psychological toll. There are so many stories of people getting another biopsy of the inconclusive ones and them coming back as normal. I don’t think it’s worth the risk of testing again though and I would go ahead with a transfer of them both and hope for the best if I were in your situation.

If I were you given you want to give these two the best chance. I would get an ERA, this means going through a mock cycle and having an endometrial biopsy. This can also act as a scratch which could improve the chance of implantation. Something to discuss at your appointment!

@Gardenlady543 I’ve already insisted on the “scratch” but until now not thought about ERA, tbh I wasn’t sure what it was.. I’ll bring it up at the consultation Monday. Thanks for pointing this out..

Will this delay the transfer? I really do want to have the transfer ASAP whilst I’m working from home and have the support from my work.. the longer it goes on they may insist I return to the office and I’m stressing over covid (particularly as I’m not having the vaccine)...

@IVFat43 it might delay things by a bit, they will do a mock cycle, on the day that would be transfer day, they take an endometrial biopsy, you’ll then have to wait for the results to come back. Progesterone is thought to have a role with endometrial receptivity, 1 in 3 women have a transfer window out of sync and need to be on the progesterone for either more or less time. There are the ALICE and EMMA tests that can be sent off as well that look at whether antibiotics or probiotics are needed. If I had 2 embryos, I would do this before a transfer. You need to give these 2 the best chance possible. I’m putting a hold on transfers to improve my chances.

Why aren’t you having the vaccine? I had my first dose a couple of weeks ago.

@Gardenlady543 that’s great, thank you for the level of detail..I’ll certainly look into it before Monday..

I’ve tried to keep my opinion on the vaccine relatively quiet, especially on these forums to save any upset but as you have asked; I would have it, but at the moment they indicate no problem with fertility issues but they don’t really know, but my real concern falls within birth defects and this won’t become apparent until many years later.. I’m of an age where I think I can wait 6 mths to see how treatment goes, if it doesn’t work I’ll be first in the queue.. it’s very scary though

@IVFat43 I will just post what I posted yesterday when someone asked me as a doctor if I’ve had the vaccine.

I know a lot of people are worried about the vaccine but there is no biologically plausible mechanism for how it could impact on pregnancy or fertility, this is not thalidomide, nor has it got anything in common with it. We have a lot of data on vaccines and they are very safe. I had the flu jab during my fresh cycle. My second dose of the Covid jab will be due in early May, so I’ll probably be having another IVF cycle at that time, and I’m fine with that. I’m fully confident that the vaccine is the best decision based on the risk I’m exposed to at work. We know that Covid can be very dangerous, I don’t want to get covid when pregnant and I don’t want to be a living vector exposing others to covid if I was to contract it because I didn’t get the vaccine.

I am fully reassured by the British Fertility Society and the Royal College of Obstetricians and Gynaecologists:

www.britishfertilitysociety.org.uk/wp-content/uploads/2021/02/Covid19-Vaccines-FAQ-1_2-logos.pdf?utm_source=mailpoet&utm_medium=email&utm_campaign=Vaccines

www.rcog.org.uk/en/news/RCOG-and-RCM-respond-to-misinformation-around-Covid-19-vaccine-and-fertility/

@Gardenlady543 I do value the information and time taken to reassure, thank you

So my PGT-A results came back today, just in time for my specialist appointment. They were good results, 5 out of the 6 embryos are euploid. However this raises more questions. My specialist is now on the same page as me, she said she suspects the two transferred embryos were also normal and agrees with me that this is likely implantation failure.

The next step for me is level 1 recurrent implantation failure tests, as I’ve been diagnosed with progesterone hypersensitivity she said she’s more convinced there is an immune issue. This will cost an additional £1,100 and will be testing for autoantibodies and thombophilia. She said immune tests can go on forever and include thinks like NK cells, but at this point it’s not needed.

We spoke about a natural cycle but she told me in my initial US scan my lining at 9dpo was 5.4mm, so unfortunately looks like I’m sticking with medicated FET. Because of this I asked about an ERA as well, she’s going to send me the cost for that, so I can decide about that.