Trying for IVF baby #2 - What would you do if you had (or have had) a mosaic blast following genetic testing?

We are very lucky to have an 8 month old baby boy from a FET. As I have just turned 41, we were keen to crack on and try for another baby. We therefore recently went through a further IVF cycle with genetic testing (due to my age). We got 6 blasts, 4 were genetically abnormal, 1 needs to be retested as they did not get a result (20% chance of it being normal), and 1 is mosaic (has both normal and abnormal cells) and therefore also requires more testing (the embryologist is very optimistic about this one as apparently the abnormalities can self-correct albeit there is limited literature on likely outcomes vis a vis genetically normal embryos). The testing will take 6 weeks.

We had not anticipated this outcome (ie grey rather than black and white). As such, we had planned irrespective of the genetic outcome to do an unmediated FET this month either using an embryo that was genetically normal (from this recent IVF cycle) or from frozen ones from our previous IVF cycle that resulted in our baby boy. We have 3 blasts remaining from that cycle but they weren’t genetically tested. It took 4 blasts from that cycle and 2 FETs (one of which was a miscarriage) to get our son.

The rationale for the further IVF cycle with genetics was to try to significantly reduce the risk of miscarriage going forward. Our doctor does not recommend genetically testing the 3 blasts from our previous cycle.

What would you do in my situation?

The thoughts whirring round in my head are:

A) Proceed with a FET with blasts from the previous IVF cycle (statistically 1 of the 3 should be normal if I am a statistically normal person - ie 30% of blasts should be normal for a 39 year old which was my age at the time of the previous IVF); OR

B) Wait 2 cycles for the results of the genetic testing in the hope we get more comfort over the mosaic blast; AND

C) Do a further IVF cycle next month to increase our chances of having a genetically normal embryo either from a further cycle or the most recent one within the same timeframe (ie 6-8 weeks).

We are not in a position that money is no object, but we could afford this if required. I am just conscious with every month my eggs are getting even older (and abnormal).

I recognise how fortunate we are to have what we have already got. But having now gotten back on the IVF journey again, all the feelings I previously had are returning. I don’t want to taint our time with our son on a fruitless quest, but equally I want to try for a short timeframe to see if we could give him a sibling.

I’d be super interested in also hearing from anyone who’s experienced having a mosaic blast also.

[Dogpark]

Hi Hidden ,

I'm 42 and planning to use PGS as well. If I were in your shoes, I would do a second stimulation cycle and try to collect more embryos in the hope of getting at least a normal one. This way, that would alleviate the pressure off of you. If you start transferring now, it might be unsuccessful and then you'll be 42 and in my shoes, with lower chances. Just my 2 cents.

[Hidden in reply to Dogpark]

Many thanks for your feedback. You and me are very much on the same page. I know we have a chance with what we have but don’t want to risk wasting 6 months or more with possible failed transfers / miscarriages.

Our consultant didn’t expect us to get 7 blasts in our previous round of IVF so dissuaded us from genetic testing. It has now turned into a total lottery in a scenario where I don’t feel we have time to waste.

I read your profile and I’m so sorry to read about your recent BFN. Until you have a baby, I recognise platitudes are just that (I have been in your shoes). However, the fact you can produce lots of blasts per cycle does mean you have a better chance at success (or that’s certainly what I am telling myself, and actually proved to be the case last time round for us).

I have 2 friends that have given birth in the past month through IVF. Both are in their early 40s. Both did 3 rounds of IVF. Neither got blasts from the first 2 cycles, and on the final round, one got 1 blast that results in her son Thomas, and the other transferred 3 day-3 embryos and now has a daughter. If this can happen for them, I think there is hope for both of us. Wishing you all the best. X

[Dogpark in reply to Hidden]

Thank you Mogwai_2, keeping fingers crossed. This is the most stressful situation I have ever been in. In your case, even if you were to have one normal pgs embryo from your first round, it would put less pressure on your shoulders at transfer to have 2 instead of 1, hence I think you should go for another cycle now. My consultant was also shocked that I got 5 blastocysts and pushed me to transfer, and now I bitterly regret it.

[Dogpark in reply to Hidden]

Also, I read some research that if you were already successful with one round of IVF, the remaining embryos would tend to not be successful, because there is only a limited number of normal embryo per cycle. So, I would prioritise collecting more embryos.

As a side note, I read your profile and your heartache at miscarriage. I haven't even miscarried yet have a similar feeling. How did you cope with the situation?

[Hidden in reply to Dogpark]

Getting a BFN is as painful as miscarrying in many ways. When you long for a baby, being on the IVF journey is one of the hardest things to deal with emotionally.

In terms of how I coped, in truth I didn’t very well. I functioned but became static in my work life (treading water) and found it excruciating to be around friends who were pregnant / had babies. I also drank a bit too much.

Our doctor wouldn’t let us do another round of IVF (ethically) until we’d done a further FET following the miscarriage as we had 5 blasts left at that stage. I had a FET during my first cycle post miscarriage (basically I just got back on the horse, even though I didn’t feel emotionally ready). I didn’t tell virtually anyone I was pregnant until I was 20 weeks as I was terrified something would go wrong. This is also a big part of why I want genetic testing now. It doesn’t remove all risks, but it can remove many. And I just (if possible) don’t want to feel like that again.

I totally know how you must be feeling. It’s a brutal journey and I know how lucky we are to even have Jack.

[Dogpark in reply to Hidden]

This is helpful thanks, now I understand why my consultant insisted that I transfer 2 embryos instead of doing another round of collection (that came from an "ethical" place). That said, when you do PGS, consultants have no issues having you go through multiple rounds. Quite a few things are weird in this process. I understand your frustration with PGS. From what I hear, if you do get normal embryos, then that's great in terms of increasing your chances, however, I hear that quite a few cycles end up with no normal embryos at our age. It's also very erratic and unpredictable. Sometimes people have no normal in one cycle and 3 normals the next. Hang in there and enjoy the company of your son!

[Lynnr54]

Hi, I can’t help with experience of a mosaic blasto, but if you can afford another round of stimms then it might not be a bad call to do it now before you get any older. If one of your blastos from your earlier cycle does work then it will be wasted money, but if it doesn’t then those extra few months might make the difference.

Just to say though, it certainly is possible to get more than one successful embryo from a cycle. I had one fresh cycle almost 4 years ago. I forget the exact number of eggs collected, somewhere around the 11 mark I think. But I got 4 blastos from that cycle. 2 of them were successful and I now have 2 beautiful sons, ages 3 and 14 weeks. The other 2 were unsuccessful (a chemical and a bfn). I was 35 when I had egg collection so slightly younger than you but my stats are not far off what is expected for a 35 year old so there is every chance that one of your remaining Frosties might work. Good luck with it all!

[Hidden in reply to Lynnr54]

Many thanks for your message and congrats on your new baby son.

It provides some comfort to know you matched the stats for your age, as our consultant believes we might too (7 blasts at 39 and 30% should be normal).

However, I am erring towards your suggestion of doing a further IVF cycle while we wait for the results of our mosaic and no-result embryo from the current round. If age was less of an issue I might wait for the results (we’re realistically looking at 2 further menstrual cycles before we can do a FET due to timeframe for results).

Thanks again, and I hope life isn’t too crazy with a newborn and a toddler!! X