PGT-A testing - recommended clinic in London please

[SunsetIntheHighlands]

Hi all

We have just gone through our first failed IVF cycle. The embryo was a 4AA and I became pregnant with an HCG beta of 148 but our numbers failed to double.

The doctor at EPU we spoke to recommended PGT-A of future embryos given this was a 4AA and all our other embryos were unviable. I’m 36 years old. We had 8 embryos. At Day 3 only the embryo we implanted was 8 cells, the other 7 were 5 cells or under with three of them not developing past 2 cells. The eggs were also extremely slow to grow during stimulation. We haven’t yet spoken to our clinic for a review but I am thinking this is an egg issue and would benefit from genetic testing of the embryos. We were previously ‘unexplained’
Our clinic is a small clinic and don’t do PGT-A testing so we would need to look elsewhere. Please can I ask for recommendations of clinics in London with an excellent reputation for this? I’ve heard the testing can damage the embryos but if done by highly skilled doctors it won’t so I would love to hear any ones thoughts on the best clinic for genetic testing please? Thank you

Thank you so much

I PGS tested age 36 after 2 previous failed transfers and multiple miscarriages - I didn't get any normals and under U.K. regulations you aren't allowed to transfer abnormal embryos so they have to be destroyed. So bare that it in mind that you could get nothing out of the round. I joined lots of groups and in countries where you can transfer abnormals lots of women were having healthy babies so I'm very sceptical of the science now. And in fact PGS testing was recently downgraded by the HFEAA as there isn't enough evidence to suggest it makes your transfer more successful.

I decided not to PGS test again and had twins on my next transfer after changing my protocol - I previously also had poor quality day 3 results but changing protocol dramatically increased quality. PGS is really flawed - I'm surprised they are pushing this after just one failed transfer when most clinics usually don't bring it up unless you were over 40 or had had several failed transfers of AA grade blastocysts?

@tiggerwhocamefortea what protocol did you change from and to out of interest? x

@tulipsandsnow

I did 2 rounds of short protocol - 225ml Bemfola with Cetrotide as required
Total 28 eggs - less than 30% fertilised - average to poor quality on day 3 and got 4 average quality blastocysts. I did 2 FET on the first round (1 BFN, 1 ruptured ectopic) and PGS tested 2 on the second round (neither normal - was allowed to transfer a low level mosaic but that was a BFN)

Then changed to natural modified IVF multi cycle package - in 2 rounds I got 9 eggs - 100% fertilised and all top quality or very good on day 3. Got 4 top quality blastocysts (2 are my twins and have 2 more frozen)

Thanks for sharing, interesting that they got so many eggs on 225ml and short protocol? Did you have high AMH for your age?

I actually had a decent response my first cycle but am always fascinated to see/hear how protocol changes can work and how one or two failed cycles doesn't mean 'the end' as such. Congrats on your twins, will you ever try to use the frozen?

OP, my clinic (Lister) does a lot of PGT-A testing for what it is worth. The stats for euploid embryo transfers are like 60%+ there.
Unlike some clinics, they charge per embryo tested, so it works out that you don't over-pay if you only get one or two embryos to test. If you get 6 or more to test in one cycle I think they discount.

Thanks @tulipsandsnow. I will look into Lister

@tiggerwhocameforteaThe embryo I transferred looked perfect, it was a 4AA, if that can’t work I don’t see the point in me continuing without testing. And I can’t take the heartache

@SunsetIntheHighlands I'm not sure your age, but a certain percentage of all embryos will be aneuploid, even with excellent morphology...the next time round the coin flip could work in your favour! It's true that transferring a tested 4AA/5AA gets you more towards 70%+ odds success rather than 40%ish for untested, but if you only get one blast many would just transfer without testing? as while it reduces risk of not working, it forces you into FET not fresh and in theory there is a risk from biopsy (though for a reputable experienced clinic I think it is very small- technology has come a long way and the laser they use to do assisted hatching/the way they take the biopsy is more advanced than even 5 years ago. The accuracy of the testing is also way higher now than 5-10 years ago, though it was high accuracy all along its very high now according to published work. One double blind study there wasn't a single tested aneuploid embryo that led to live birth out of 200, implying the test results identifying embryos as abnormal were approaching 100%, and/or it would be extremely rare for an abnormal to lead to live birth- as if it were at all common would have probably happened within a sample size of 200.)

@tulipsandsnow
My AMH was actually below average for my age

@SunsetIntheHighlands
That is the hard decision - id already had 5 miscarriages and 1 ruptured ectopic by the time I started IVF - I said to my clinic if it was a choice between having another miscarriage or giving a blastocyst a chance then I could deal with a miscarriage

Most people I know who PGS tested....their AA grades were the abnormal ones and their lower grades were normal....

Unless you tested the miscarriage this time round there is no guarantee that there was anything chromosomally wrong with the baby - there could have been many other factors which caused the miscarriage which is why I'm surprised your clinic has advised it after your first one

It's worth considering with the HFEA traffic light system that it's based on the chance of an 'add on' increasing your chances of having a baby, PGT-A doesn't claim to increase your chances of having a baby, it's aim is to decrease the chance of miscarriage and genetic abnormalities and to shorten your time to live birth by highlighting embryos not effected by aneuploidy

We had our embryos tested with the Evewell. I trusted their embryologist enough to test when one cycle resulted in just one blastocyst (came back normal). Their stats for euploid transfer are about 70% confirmed pregnancy, 60% live birth.

My goal wasn’t to get pregnant, it was to get a baby so it was important to me that we did not risk the transfer of aneuploids.

Would very much recommend lister. They were excellent for us for PGT-A testing. And as PP says, they charge per embryo tested which seems by the far the fairest way to me but is not common. One round I had one tested which cost £400. Another round we had 7 which obviously far more expensive. But each time the charge felt fair.

They have good results and there were no issues with my testing as far as I am aware so far.

At one stage we contemplated moving to CRGH but I just couldn’t get over the cost of the testing, even if you only got one embryo to test.

@SunsetIntheHighlands I did testing at CRGH and whilst it has been good for me I wouldn't recommend as they charge a large amount for testing up to 6 or maybe 8 embryos (can't quite remember which). It makes it super pricey to just test one. Lister sounds a good option.

Btw they don't transfer aneuploid embryos here but they do transfer some mosaics and, from what I've read, those are the ones that have been successful in overseas studies showing success with "abnormal" embryos. Of course there may be other studies I've not seen saying something else.

Best of luck

Xxx

Thank you for all your advice and help, you’ve given me lots to consider x x x

Hi everyone, just an update - we are seriously considering Lister and are looking at the Access packages with PGT-A.