I had an egg collection last Friday and we will be PGT-A testing any viable embryos on advice of our consultant as we already have had two miscarriages and two failed FET cycles, plus three failed IUI cycles.
We'll be getting an update from the embryologist tomorrow about viable embryos. It will then take a few weeks to get results from the PGT-A testing if all goes to plan. I just wondered if anyone had been in a situation where none of the embryos they tested were normal and whether they were advised that another full ivf cycle might produce different results? Or perhaps if people only had one normal embryo that they then transferred and it didn't work.
I know it may all work out but feeling less hopeful as the years of infertility treatment go on so want to manage my expectations.
Thank you xxx
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Citizenerased83
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Hi, I can’t offer advice on PGT I’m afraid as I have never paid extra for that but I wish I had. My last OE cycle produced 3 ‘top quality’ day 5 blastocysts yet two of them failed to implant and the last one was a blighted ovum. It took from an October egg collection to June the following year to complete the 3 failed transfers and I was 42 at the time. I wish I had tested them and saved the time or had a double/ triple transfer because after that time had passed I was then nearly 43 and have moved to DE as I realised age is not on my side. So I guess from my ramblings… better to know and have a clear idea of chances, then if you need to there will be time for another collection. My understanding is that x number of eggs per x are normal so you don’t know when the ‘good eggs’ will come up so each collection can yield different results. Best of luck xx
Thanks so much for taking the time to reply Kitkat10 and sharing your experience. I'm so sorry you've had such a difficult time and I wish you well on your donor egg journey. We were really ensure about doing pgt-a when we had our first ivf cycle but now wonder how different things may have turned out if we had. I turned 40 a few weeks ago so not losing time is on my mind. Thank you for your well wishes. Xx
Hi. I’m afraid that my story isn’t a positive one, but here goes. I’m 44 and had my first IVF cycle in May this year. I got 16 eggs, but most of them deteriorated by Day 3. I ended up with 2 blastocysts and sent them both for PGT-A testing. Unfortunately, they both came back abnormal. I’m quite a stubborn person and don’t like giving up easily - especially as I was reacting well to the IVF meds and still producing a lot of eggs. I agreed with my consultant that I would do another cycle - but on the proviso that we would ‘change things up’. So - try and improve the quality of the embryos, even though there might be less. However, he still warned me that I only had a 3% chance of success. We tweaked my meds, introduced Growth Hormone, and did a double trigger. I ended up with 3 blastocysts this time, including a pretty perfect looking 4BB. However, all 3 came back abnormal after PGT-A testing. In the back of my mind, I do wonder if I would have found that one special Euploid if I kept going - but I just didn’t have the mental energy to go through it again. I’m now in the middle of a donor egg cycle. Wishing you all the luck in the world xx
Thanks so much Football61 for sharing your experience of pgt-a with me. I'm sorry it didn't help things for you. That's really tough to go through. It couldn't have been an easy decision to move on to donor eggs. I really hope it works out for you. Thank you so much for your well wishes. Xx
worth checking with your clinic but we were advised that if we tested 5 and none of them came back normal then chances are that no further testing would produce normal results and we’d be best off doing no further IVF. Just to reference the comments above and manage expectations, whilst also hoping for the best for you, from the 5 we tested 3 came back normal - so far one was a chemical and the other was a blighted ovum/MMC picked up at a 7 week scan so the process is no silver bullet. It does however save time and can be reassuring if you get some back normal that you’re still producing ‘normal’ eggs and it’s worth proceeding with your time/money and emotional investment, if that feels right for you. Best of luck and hope this helps
Thank you Bookbroad for sharing your thoughts and experience. I hope things really work out for you. I will ask my clinic about what you mentioned about testing 5 embryos.
You're very right about pgt-a not being a silver bullet. I know it won't necessarily guarantee success but transferring embryos one by one as we have done with no success has been too much. Fingers crossed we get some normal embryos but I'm trying to prepare myself for having to do another ivf cycle. Xx
Don’t have an uplifting story for you I’m afraid but wanted to share my experience.
I’m about to turn 43, have had 4 ivf cycles including 5 transfers, OHSS needing a hospital stay and 2 miscarriages at 5 and 7 weeks. All this over the past 18 months or so.
The last cycle was the first one in which we PGTA tested. We had 4 day 5 blastocysts but unfortunately they were all abnormal.
Whilst it was a huge sucker punch, the detail in the PGTA report told me the exact number of the chromosomal abnormality, and when you see that, or at least when I did, it put things in perspective for me. For me personally, I’d rather transfer chromosomally normal embryos- not that it’s a guarantee of course. But it does make me regret the lost time with the miscarriages and recovery and I do wonder if they were abnormal which is most likely given my age.
After that cycle I had two different opinions from 2 clinics, one recommending the donor route straight away and the other recommending trying again with my own eggs in the hope of finding a normal embryo. I have PCOS so their thought process was that hopefully I’d have more eggs and out of these I might just be able to find a normal one which just might lead to successful outcome but not a given.
I have one more own egg cycle in me and at that point I think I’m ready to close the door on this and move on to a donor.
Thank you so much for your thoughtful message. It’s so kind. To quote Elton John, “I’m still standing!”
I guess like most people going through this journey you get on with it and maybe once you get to the end (with hopefully a positive outcome), that’s when you actually process all you’ve been through. Xx
Hi Citizenerased83 hope you are recovering well and coping with the wait. Sending you lots of positive vibes!
Unsure if my story will help, but here it is:
We did our first egg collection in Jan this year. We got 4 embryos and PGTA tested. One was normal.
Due to the clinic pricing structure (the price at our first clinic was the same whether you get 8 embryos or 2! Same price up to 8) and recommendations based on my age, we decided to do another round. In April this year we got 5 embryos. None were PGTA normal.
In July we had a FTET of the one PGTA normal embryo from January. It failed.
I was completely destroyed both physically and mentally. At this point IVF had exacerbated a pre existing gynae condition, so I was sick of the pain and the hormonal rollercoaster.
But we decided to try again. One more time. In November we moved clinics. The new clinic changed our protocol and was far smaller so they had a lot more time to spend with us. I don’t know if that had a bearing on the outcome, but I had FAR less pain and they handled my OHSS brilliantly. So it all felt a bit easier. We got 7 embryos and 3 tested PGTA normal.
Their grading mean they are by no means a sure thing, but I really didn’t expect it. I’d lost all hope.
We are still very realistic about our chances given embryo gradings and I am almost scared to be too hopeful, but I can’t deny this round in terms of yield and PGTA normalcy has been really lucky compared to the first two.
But. It’s important to say I’m not in the best way emotionally and I think that’s a huge factor. Not to mention the financial aspect (just YIKES)
I’m enormously grateful for a lucky turn (and also terrified it won’t last) but there is part of me felt I was done after two ECs.
I think it’s super important to consider your physical and emotional capacity for more because it’s so easy to put it to the side and keep pushing beyond it.
Hoping you get good results. I’ll be thinking of you. Take so much care of yourself as you’re waiting. Sending love x
Hi Sharry, I hope you don’t mind me jumping in on this. Was just wondering if you’d mind sharing the protocol change when you moved to your new clinic? Thanks, x
Hi there, I replied to Elmo13 below on this, but haven’t included drug names because I’m not sure if that’s allowed etc and it was super specific to a. My reaction to previous rounds (a lot of pain and a bit of OHSS) and b. Having endo and adenomyosis.
But I’ve replied with some of the things I think led to a higher egg yield (which actually wasn’t what they were aiming for - they wanted it lower to try and increase quality but it almost doubled).
One month on from the last EC and I’m still in a little pain but it’s defo been better than the other two rounds even with double the follicle count.
Happy to share the difference in drug protocols if it is allowed or by DM. But basically a lower dose of a different stim drug and the use of a steroid during stims. I also started on OHSS meds a few days before retrieval. Xx
Hi PinkCat22, thank you so much for your reply. Wow, that's a lot of rounds of IVF to go through and I really hope that the embryos that have tested normal work for you and you end up with some precious babies.
It must have also been a lot to change clinics but I'm glad that they have been brilliant and looked after you.
I agree about having to weigh up the financial/emotional/physical impact as it is so so much to deal with. I think I'm mentally preparing myself for no normal embryos and another ivf cycle so I'm trying to be as healthy as I can at the moment.
Thank you so much for your good wishes and kind words. X
I’m not sure what’s allowed and what’s not in terms of sharing specific protocols/medications on this forum? It was very much tailored to suit me having quite a strong reaction to the drugs and flare ups of both endometriosis and adenomyosis when I had my first two egg collections, so maybe a bit specific to be helpful.
Basically it was a lower dose of a slightly different stim drug and the addition of a steroid to calm things down (after my failed July FTET, my endo flared so bad I was admitted to hospital twice to manage flares, so things certainly needed calming). Happy to share drug names if that’s allowed/helpful but not sure if it is?
I’ll also say my understanding is that whilst the protocol can help embryo grading, getting PGTA normal embryos is a bit of a roulette and can’t be affected by the drug protocol so much.
That said, I responded better to these meds (the new clinic really dug into my previous two cycles and tried to learn from them). So I got a far higher egg yield due to that, so I think that gave us better odds on the PGTA roulette!
I also think my first clinic (which we went through the NHS with on the first round and privately on the second round) was a deeply stressful place to be and on my second collection let me go over my retrieval time (crying in pain in a waiting room past the intended procedure time). It was painful all through stims and by the last few days it was pretty horrific. perhaps my body didn’t like that.
The second clinic (3rd round) was a totally different environment and experience. I felt cared for and calm through the EC & stims and I think that helped so much. The first two felt borderline traumatic!
Sounds like you’ve also really been through it with your experience at your first clinic. I’m so glad the second clinic was so much better 😊 and you were actually looked after.
You’re right about PGTA being a roulette. I’m hoping that I’ll have a decent enough amount of eggs to perhaps get a normal embryo- not that it’s a guarantee. But I know if the outcome is the same with all abnormal then at least I can close the door on this and move forwards via donor. Have come to terms with it- I had to after the last cycle! Xx
I don't mind sharing my story I did 4 embryo batching cycles in 2022 and then Jan 2023. We thawed all of them they were frozen on day 3 to grow to blasts. I got 9 eggs. 6 eggs. 3 eggs. 2 eggs each collection. ...
I had 7 embryos day 5 and two stopped growing.
I was really sad.
I thought it was game over.
Four were sent off for pgta and surprisingly two came back as normal. And two abnormal.
The other two had chromosome issues and it was helpful to see which ones such as -5 and -16.
It was helpful to know.
For us, we haven't had any embryo transfers yet because I have on untested embryo at my old clinic and hope to use this first, and recently conceived naturally until 5/6 weeks then miscarried. So needed a break.
Our embryos are good quality and 6 Ab which in with the clinic grading is a day 6 as All pgs can get to day 6 then sent off.
Hey Poop84, thank you so much for your reply. I'm really glad you got some normal embryos after the pgta testing. Wishing you so much luck when you come to transfer, especially after 4 egg collections and miscarriage. Thank you for your kind wishes. Xx
I did PGT testing this cycle at aged 41. I only had one embryo to test in the end and I am currently 5w 5 d pregnant.
My previous cycle ended in miscarriage.
I had been given a 3.4% chance of conceiving after my last miscarriage. I decided on the testing due to lack of funds and the fact that I wanted to know if I was transferring a chromosomally normal embryo.
You may want to ask your clinic if they would consider transferring low level mosaic embryos as mine classed those as suitable for transfer but I know not every clinic does.
Hi lovely, at 42 my husband and I did three back to back egg collections that resulted in 5 embryos, all came back abnormal. Our clinic then said we could try again if we wanted to. They suggested three cycles again because PGT is so expensive and my volume of eggs was good, I believe they call it batching. We tried again and got 6 embryos from the next 3 cycles, again all abnormal. It was an awful time but we moved to DE and a new clinic and we are now 12 weeks and expecting next June. There are options and it’s good to be clued up and prepared for all scenarios. Wishing you all the luck on your journey, I know too well how tough it is. xx.
Thanks so much Yellowlove for your reply. I'm so sorry you went through all of that and then had no normal embryos. That's so much to process and deal with. I know moving to donor egg couldn't have been easy but I'm so pleased to hear you're now pregnant.
Thank you so much for your kind words and well wishes. Xxx
Hi there, I am on an over 40's group on Facebook and a few ladies have had to go through a few rounds before finding a euploid. One lady did 5 rounds, and on the last round after taking supplements for 4 months she get her best result and euploid. For me personally it has helped as I produce good number of blastos. When tested 1 came back normal. Before testing I had failed transfers and the ones that stuck were likely normal but I lost those for other reasons. Once you get a euploid it's only 50% of the picture. You then need to look into anatomical and uterine environment. I also needed to do infections and microbiome testing/hysteroscopy need thyroid support and blood thinners. All the latter issues caused miscarriage for me. But it's equally heartbreaking to transfer quite a lot of top quality blastos with a negative. My first clinic never suggested that PGT-A could have helped narrow down the transfers and would have saved time, money, and emotional turmoil! Good luck x
Hi Masief, thank you so much for your reply. I'm so glad PGT-A testing helped you. I'm so sorry for all your losses though. So hard.
That's interesting about the supplements. Do you know what she took to help?
I've had lots of blood tests to see if they could find reasons for miscarriages but nothing concrete really came back but blood thinners have been added in to start a few days before a FET transfer. I've got an underactive thyroid and on medication for that and also was advised to take a course of probiotics before the last FET in case there was an infection. Not had any anatomical tests aside from the standard tests they do when you first go to the fertility clinic.
Hi! Just wanted to say a couple of things. Age is the 800 pound gorilla in this room. Many of the stories of the journeys below involved women above the age of 40. It’s frustrating but very true that women in that age group have much more of a challenge getting to PGTA normal results. Just a few years difference can be game changing. Also, reproductive endocrinologists use antral follicle count, and fsh/AMH levels to pretty accurately predict your likely success. You didn’t mention your age, but I wanted to put these metrics out there for clarity.
Now I’m afraid I’m going to muddy the waters a bit. PGTA testing may not be as accurate as we would all like. The cells that are taken from the blastocyst are not taken from the inner cell mass, which becomes the fetus. To do so would destroy the fetus. The cells are taken from the outer cell layer that will become the placenta. Typically 5 to 10 cells are taken to be tested. In theory the cells taken should have the same genetic makeup as those of the inner cell mass/fetus, but there’s some doubt built into the equation.
You may have heard of “mosaic” test results. This is when some of the tested cells are abnormal and others are normal. If the ratio of abnormal to normal cells is low, and the genetic error isn't a particularly bad one, these are labeled “low mosaic”. It’s been shown that when these low mosaic blastocysts are transferred, if pregnancy occurs a baby is often produced without any abnormal cells.
There are a couple of theories that I’m aware of. One is that early in development, the inner cell mass/fetus is able to push abnormal cells out and into the cells that become the placenta, getting out of the developing fetus. Kind of like taking out the trash. Since these are the cells that are sampled during PGTA testing, if this theory is true then you would expect to find the abnormal cells here, but not necessarily in the developing fetus. The other is that the early fetus may have ways of repairing mistakes in individual cells with genetic mistakes. Both of these mechanisms, if they in fact exist, would make sense from an evolutionary point of view. There’s no reason not to believe that early development has evolved ways for a fetus to survive by correcting errors made during early cell division when the total number of cells is still relatively small.
If one gets a report that lists a blastocyst as “low mosaic”, that means that abnormal and normal cells were found, and that less cells have a genetic mistake and more cells are normal. And these blastocysts can be used for transfer, at least this is so in the US. I don’t know the protocols for the UK.
All of this raises the uncomfortable question of whether viable blastocysts are being overlooked and discarded. Of course if most or all of the cells from a PGTA test are abnormal, it’s probably a good bet the blasto is not a good candidate.
There was an interesting experiment done at a rather famous fertility clinics in New York City called the Center for Human Reproduction. Using a fairly small group (around 10 I believe), of donated blastocysts, cells were taken and sent to two prestigious PGTA labs. The results were practically opposite from the two labs. Blastocysts that were deemed flawed by one lab were deemed normal by the other and vice versa, bringing into question whether such testing is as conclusive as it is treated. There are grumblings from certain medical personnel that genetic testing should be done away with. But absent of any other options, it remains widely used.
I don’t stand on one side of this issue or the other, but I do believe there may be some concerning ambiguity. In the majority of cases of the entire population of women undergoing PGTA testing, some normal blasts are typically obtained, so there’s no good reason to consider the ones that don’t pass muster. But I worry about those women who have low yields and few or none are normal. I wonder if there might be a chance in some cases.
Anyway, as I prefaced, I may have muddied the waters for you. But I believe that women with more information are better off during their journeys. I suggest you do your own research and speak with your doctors. Write down your questions and bring them in with you.
This is so interesting. At 42, I had 9 blastos from my first two rounds and only one was normal. The rest completely abnormal. They used the Juno platform. The normal one was transferred but failed.
On our third round with a new clinic, I got 7 embryos in one round. I was a week off turning 43. Three tested normal. I believe they used a different PGT lab and part of me is scared I’ve abandoned healthy embryos by testing. But at my age, the clinics did advise it to avoid failed transfers. Still, it’s worrying.
Thanks so much for taking the time to write to me and for such a detailed reply.
I have read up loads on PGT-A testing and spoken to different doctors as well so understand the differing schools of thought on whether it's worth doing or not.
We definitely got to the point of being ready to give it a go though as the trauma of transferring embryos one by one was huge and has either resulted in miscarriage or negative pregnancy tests. We'll see how we get on with the PGTA testing.
I had PGT testing. I had high AMH and high follicle count. In my first round (age 36) 2 were ‘normal’ and 3 were ‘mosaic’. The two normal embryos failed to implant. In my second round (age 37) 2 were ‘mosaic’ and 1 was ‘abnormal’.
We made way more ‘mosaic’ embryos than most people for some unknown random reason. We did loads of research and found that some mosaic embryos had almost as much chance as normal embryos and so after some more implantation failure tests we did an FET with one of our best mosaics and I’m now almost 28 weeks pregnant and so far so good 🤞🏼.
So all I would say is even if they aren’t ‘normal’ that mosaics still have a really good chance ☺️
Im really glad we tested ours because our normal embryos failing was what made me do more testing on myself and found some immune issues which we then could rectify for the mosaic.
Hello Wishinandahopin, thank you so much for your reply. That's great news that you're now 28 weeks pregnant and all good so far. I hope that continues and your little one arrives safely.
Hi Citizenerased83, my experience with PGT-A testing has been a mixed one due to a unique set of circumstances, but hopefully it will give you some hope. I started IVF at 41, high AMH and AFC and was told by my fertility specialist that due to my age I should be testing my embryos. As he also mentioned that nothing can be done about egg quality I was not taking anything besides Ubiquinol and Omega 3.
After 4 cycles of IVF I had 10 embryos: 4 transfers - all BFNs; 6 embryos sent for testing - all abnormal. I then decided to do a research on supplements to improve egg quality and, after taking them for a few months, did another cycle. On day 5 I had 6 embryos ranging in grade from AA to BB. However, as I was told there were not enough cells to test/embryos too fragile, a decision was made to leave the embryos for 1 more day and take the biopsy of cells then. That was a decision I regret to this day...
The following day my embryos started to degenerate or have already degenerated. I was beyond devasted and the clinic's explanation was it was due to egg quality. 2 embryos were saved (AC, which was AA and hatched BB, which used to be a hatching AB) and both were sent for testing. The hatched BB came back as euploid (so much for my clinic's egg quality explanation!), but since then I made a decision that if an embryo can't be tested on day 5, I will not test it and freeze it as soon as possible.
Long story short, after 2 more rounds of IVF and 2 more rounds of unsuccessful transfers of untested embryos, I decided to do a few more tests and do downregulation for adenomyosis before transferring the euploid embryo. Well...that embryo stuck and I am currently 9w1d pregnant at the age of 44! It is still very early days and it still feels very surreal and scary, but it can happen for women over 40! Don't lose hope and I wish you all the very best on your IVF journey!
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