So, one of the things we did last week, just before I trotted off to the hospital, was spend an hour with the senior lab lady at our clinic talking about PGD. I have forgotten what the acronym is, but basically genetic testing our embryos before transfer.
There a number of issues to consider. We have ended up in this corner because none of my otherwise “perfect” embryos have ever taken and because I have 4 miscarriages as well. One of the main causes of these issues is aneuploidy. So, genetic testing for this. But not for potential translocation, because we have both already had karotypes done.
The clinic doesn’t do the tests, the biopsies get sent down South to another company. The cost is $$$$$.
We have to do a frozen cycle- ie we collect eggs, fertilise and then freeze all viable embryos. This is not an issue, was already on the cards. Possibly better, as allows for focus on egg maturing and collection without having to balance uterine lining.
We have to do ICSI. This is because the other fertilisation method of putting an egg in a bath of sperm means that there may still be genetic material of the failed ones plastered on the edge of the embryo, and that will contaminate the biopsy. Again, this is actually something we have done, so not an issue.
The biopsy for testing will be on day five. My clinic pretty much only does day 5 transfer anyway. Her reasoning was that the main drop off point is usually between days three and five and this way we only test ( and pay for) the really viable ones. And I have seen some stats ( different Aussie clinic) that show substantially better live birth rates for five day tested embryos. I have also seen conflicting info on this on various blogs. In general my clinic seems to prefer 5 day transfers, and the people testing are also proponents of this ( it’s another clinical group). Downside is the risk that there will be none appropriate for testing by that point.
We have not had great luck with embryos ( this was discussed). We have never had enough to freeze at the end of cycle, but we have always had at least one. And the overall stats were from 16 fertilised eggs we ended up with 4 transferable blastocysts. So theoretically, a protocol focused on egg quality, maturity ( an issue for me) and number could yield more. Plus, as it is a frozen cycle and the biopsies are frozen, we can do a couple of cycles and bank. The $$$ test covers up to 8 embryos. So we could do cycles up to that point ( it’s per embryo costing after that)
There are risks with freezing, but that was already a risk. There is the risk that we have none that are genetically normal, but that just means we don’t have to go through transfer before our hearts break.
One issue I was considering, what if we egg collect both me and my sister at the same time. That would yield more ( maybe). If we test all, and none of mine are normal, we go straight to the egg donor route….