PGT-A testing - is it a good idea?

[BelleCrescent]

Hi everyone, I was just wondering if anyone here has had any experience with PGT-A testing? We're just planning our second IVF cycle which will be self-funded. I'm 41 yo and my husband is 42. Our fertility clinic recommends that we try PGT-A but I've found contradicting advice on the HFEA website. Sounds like in some cases it could cause harm to the embryo, and the results are not always reliable. It's also very expensive, as we're doing a DuoStim, we may end up with a few eggs that need to be tested. Any advice or sharing of stories about your own experiences would be appreciated. Have you tried it/would you try it, and how did you find the process if you have? Thank you. :)

We're doing it. It reduces the chance of miscarriage and increases the chance of pregnancy and live birth. At this stage in our journey (3+ years of fertility treatment), we don't want any more heartache if we can avoid it.

The risk to the embryo is extremely small and really, if the embryo isn't robust enough to withstand it, then it probably wouldn't have resulted in a viable pregnancy.

My partner and I did it for our second and third rounds of IVF. We had been through so much at that point that I didn't want to go through with a transfer and everything if the embryo had no hope of making a baby. I think the risk to the embryo is very minimal.

Thank you, both. We decided to go for it, I agree that it sounds like a good idea. I just had a momentarily confusion after having loads of info dumped on me about add-ons and their pros and cons. It's difficult to know which add-on would be useful, but the PGT-A testing definitely seems worth trying. I wish you both the best luck with your treatments!

I went for it as advised by the drs as I had a mmc for chromosomal abnormalities. I haven’t transferred yet but I had 5 high quality embryos. Only 2 out of 5 were euploid. The best quality one was complex abnormal as were the rest. They had to be discarded. I am nervous about the fet now but I do think it’s highly unlikely the results were incorrect on the abnormal embryos. I had 20 eggs collected and only 2 euploids. Been ttc now for 3 years with no hint of a bfp apart from the miscarriage so think egg quality definitely an issue. Best of luck with everything!

I would follow the HFEA guidance. It's there for a reason and represents best practice based on current research. They only recommend PGT-A for people who have experienced recurrent pregnancy loss as it may reduce the risk of miscarriage for these individuals. It doesn't increase your chance of pregnancy and there is a risk of losing viable embryos. It is grossly overused by clinics to generate additional income.

I wish you luck! I should have mentioned that my treatments all happened in 2021 and I now have a 2 year old daughter!

The embryo that became my daughter was euploid. We also have a low mosaic embryo that we'll be going back and using next year.

@Missmarymack2 Thanks for sharing your experience. Interesting to hear that high quality embryos aren’t necessarily euploid. I don’t want to keep transferring embryos that have no chance of surviving so PGT-A seems like a good idea… I hope your fet goes well, I wish you the best luck too!

Thanks @SErunner , this is exactly what I was afraid of. There’s lots of add-ons they are trying to sell I wouldn’t bother with, but now I feel like PGT-A is one that’s worth doing. My age and a previous miscarriage are the reasons why… But I agree they really take advantage on people’s desperation and charge huge sums of money!

Thanks @doiwakeorsleep, that’s lovely to hear! Congratulations on your daughter. 😊

@BelleCrescent hi, just wanted to share my experience with PGTA.
I did 3 EC when I was 41, we got 10 embryos tested but all uneuploid 😔 So we ended up with not even trying the transfer.... I have 2 kids naturally, all hormones good etc., but as had 4 cp decided definitely will do testing.. Maybe it was still a good decision, just this sad feeling I didn't even try transfer.. If I did another one I decided not to test. But different doctors now say no, donor only as definitely qualify not good.
So just be mentally ready for this possibility (I wasn't tbh)

@BelleCrescent thanks. The mmc was such a horrendous experience and I didn’t want to experience that again. I am aware that there is no guarantee it won’t happen again, that’s if they even implant. I can understand people not doing it though.I think if I was younger without my history I would take my chance without it. I was 36 at the egg collection and am really only willing to do one round so I wanted as much info as possible. As you are 41 I do think it is definitely worth considering especially as this is your second round. I know it’s not recommended in the uk by hfea but judging by multiple Reddit threads I have read it seems to be done mostly as standard in US even in young women. If only I had insurance and could afford multiple rounds, unfortunately I can’t !

I did PGT-A following recurrent miscarriage and it gave me so much more confidence knowing I was only transferring euploid embryos.

I think most clinics in the UK only recommend PGT-A where there is a history of recurrent miscarriage or maternal age of over 37, when the aneuploidy rate typically increases to over 50%. There’s an embryologist called Emma Witney (who you can find on Instagram or her own website) who has written/ spoken extensively about the science behind PGT-A. She has a podcast episode dedicated to this. She explains in full but basically, embryo biopsy, screening and vitrification processes have advanced massively in recent years, so the risk of damaging the embryo or getting inaccurate results is very low. It obviously doesn’t improve the live birth rate overall, but it does reduce the risk of miscarriage and failed transfers.

In my own experience, it was part of the rollercoaster of IVF… It means doing a freeze all cycle, and creates an additional wait after the embryos have been developed to day 5. It was psychologically very hard waiting to hear if I had any euploid embryos as an additional stage in the IVF funnel. It took about two weeks from the biopsies being taken (from day 5 blastocysts) to getting the results. It was an agonising wait. But it gave me so much confidence to go ahead with embryos that had been tested and were chromosomally normal.

Though PGT-A is expensive, I think you also have to factor in the financial (as well as psychological) cost of multiple failed transfers if you are in an age group with a high risk of aneuploidy.

Wishing you all the best with your treatment.

I'm reading the book it starts with the egg and there is a section on it 🙏

I've had 3 MMCs whilst TTC my first, the last of which was confirmed as having trisomy 15, and the other 2 were suspected chromosomal abnormalities too, so if we go down the IVF route (currently having fertility tests done as part of our referral) we would go for PGT-A due to our history. We have had genetic bloods done and are waiting on those results too.

We did PGTA testing at our clinic in Spain after MC, molar and TFMR for brain abnormality.
They said they used a relatively new method that was just as accurate and did not harm the embryo because (from memory) they test the fluid the embryo is in as the DNA has transferred across to it (I think that’s how it worked!)

They actually gave us the choice between the invasive method and the non invasive method so we chose non invasive as they said it was the same in terms of accuracy.

I did two EC (age 37 at the time) and only 50% of the blastocysts were euploid so I was glad that I didn’t go through the stress and heartache of potentially transferring an embryo that would result in MC
That said the first transfer didn’t work and now I am pregnant naturally so I am dealing with anxiety of not knowing it was a tried and tested euploid embryo 🙈

Hi @TT82, sorry to hear about your experience, it must have been difficult to make it that far and not being able to transfer. And thanks for the warning! We were told this was a possibility so I'm trying to mentally prepare myself.

@Missmarymack2 I agree, I'd do anything to avoid another miscarriage! Tbh the HFEA website only confused me further. We'll try PGT-A in our next try and see how it goes. IVF is so expensive, isn't it, we're just calculating how much we can afford and it's scary...

Hi @sweetpea2000 , thank you so much, your comment was really helpful! I'm just listening to the podcast and finding it very interesting. I'm anxious about that long wait but sounds like it's worth it. We were also thinking, to avoid multiple transfers which are both expensive and stressful, it's best to go through PGT-A. May I just ask if it resulted in a pregnancy for you? I wish you all the best, too.

Thanks @Lil89 , I was thinking about buying that book, good to hear they cover this topic, too.

Hi @moosey89, Really sorry to hear about your 3 MMCs! Sounds like a good idea for you too, to go for PGT-A. I hope it all goes well.

Thanks @Caipulli, it's interesting to hear about this new method. And congratulations on your pregnancy, that's wonderful news! I hope everything turns out well for you. :)

It's very good! I would recommend 🙃

Yes, my first transfer was successful and I went on to have a baby last year.

@sweetpea2000 Oh that's wonderful, congrats! :D

We had two NHS funded IVF rounds with TFP Fertility last year (age 36), but decided to pay for PGT-A testing on the 8 embryos from our second round. As our NHS funding had finished we would have to pay for any subsequent embryo transfers, so didn't want to potentially pay to try 8 abnormal embryos without knowing. The testing resulted in identifying 6 normal euploid embryos out of the 8. I had the first one transferred in January and am now 34 weeks pregnant with a healthy baby 😊We have 5 left in the freezer.