PGT-A … to test or not test ???

[TeddyBear5]

hi all

I’m about to go into egg collection and about 70/30 on not testing.

I have had one previous round of IVF in 2015. One embryo (fresh transfer) is now 6 years old and I did a FET with the other last year. I did get pregnant (so I don’t have issues with implantation) but the baby had a chromosome issue so I had to terminate.

I just don’t know what to do for the best. I don’t want to terminate again - but neither do I want to limit embryos. I’m going into it trying to be realistic and understanding I may miscarry or have another termination.

I just don’t want to test and get abnormal embryos that could have corrected themselves. Or to damage the embryos.

Any advice ?? Thanks 🙏

[DreamingOfTwo79]

Hi TeddyBear5, first of all I'm wishing you all the best and lots of strength for your upcoming egg collection. We are of a similar age (I am 43, soon 44). I had two cycles of back to back embryo banking and out of my 5 good quality blastocysts 2 tested euploid after PGT-A. In my age bracket with 4-6 embryos to test I was given a 21% chance that one of them would be euploid so I do feel that my result is exceptional and I am grateful beyond words as I fully expected to have no euploid embryo. [... I misread some of your post so deleting my response to this, apologies,] In our case I was absolutely not prepared to risk another loss and needed to know for my own sanity that I had done all I could to give my baby the best chance of being born before falling pregnant again. There is definitely a risk that perfectly good embryos are being discarded in the process, either during PGT-A or even as part of the embryo observation in the lab before they reach Day 5, each clinic have their own policy. Your age is only one factor, the sperm quality will also play a part in assessing your chances of achieving a euploid embryo at 42. In our case we also had high DNA fragmentation and advanced paternal age to content with so PGT-A was definitely the right choice for us. If this is an option for you, back to back embryo banking has shown to have benefits when you're aiming for a higher number of embryos before you decide if you want to test. I wish you all the best, and listen to what feels right for you. xx

[TeddyBear5 in reply to DreamingOfTwo79]

thanks so much for your reply. I’m so happy for you that you had two good ones! That’s fantastic.

It’s such a hard one! I’ll have to wait I think to see how many eggs fertilise and go from there.

I think our sperm is pretty good - it’s donor sperm. I feels it’s my eggs that will be the issue. I also think I read that they determine any chromosome issues.

I guess I need to be lucky to get any embryos first. I have a gut feeling that I’ll get a couple - but that’s probably based on my last ivf experience. I’ve got a similar number of follicles to before - although being a few years older I guess will have a big impact.

I’ve been taking ubiquinol for the last year - I’m so hoping it’s helped the quality!!

I can’t imagine having another termination- but I am much more prepared now for whatever is thrown at me. If I get pregnant I won’t accept it until I’ve had my NIPT and I’m at least 20 weeks. It’s so sad to be so pragmatic and realistic but I need to protect myself this time. On one hand I think I’m nuts for testing - on the other I think it’s just too much of a risk. Life!

[DreamingOfTwo79 in reply to TeddyBear5]

I am sorry, TeddyBear5, I misread some of your post. Yes, the heartbreak involved with an unsuccessful pregnancy and I imagine especially when you have to actively make that decision is something that stays with you for the rest of your life. I am so sorry you had to go through that and here's praying that you will never have to again. Back to back embryo banking cycles might be a good option if you are not confident to get many embryos in one cycle, my consultant recommended it to me due to assumed diminished ovarian reserve. I would always opt for testing again even though waiting for results was excruciating. I know there are still no guarantees that we will be successful with our two euploid ones but apart from the emotional anguish and grief after each loss I felt I was also running out of time to keep trying and failing repeatedly. In our case, if we had chosen to transfer without testing, worst case scenario we would have had three more miscarriages or failed transfers before finally getting a real chance at success, by which time we would probably be past the age we personally feel confident to be new parents again (my partner is 58 next month). It is a very personal choice, trust your heart. xx

[Skittles11]

I totally understand this dilemma. I have also had to terminate a wanted pregnancy, an IVF pregnancy, due to T18. I went through a similar battle in terms of whether to test my embryos or not following this devastation. I have low reserve so the decision was very difficult because I knew there would never be many embryos to test.

I decided that I could not face another termination for medical reasons and needed to do what I could to avoid this. So I did test my embryos despite only having two. I have to say it is a decision I found extremely tough and even now if I go to another fresh cycle I will face the same dilemma again.

This decision is extremely personal and there certainly is no right or wrong. There is mixed research and evidence too. You probably have a gut feeling and sometimes it is best to go with that alongside your clinic's recommendation. Xx