just wondered if anyone had thoughts/experience about the minimum number of blastocysts to proceed with PGTA?
We are opting to do for first time after many failed cycles/rounds.
I’m a poor responder with low AMH so even with a change in protocol this time I may not get many eggs (had 1 blast from 1 egg, then 3 from 4 (4th was immature though), then 2 from 4 (4th again was immature and one arrested on day 3)). The recurrent implantation failure mean I’ve been suggested and keen to do PGTA.
However if we only get one or two blasts is it still worthwhile? My clinic seem to suggest 3 or more? After experiencing previous losses (biochemical and ectopic pregnancies) though I am really keen to avoid transferring an untested embryo and losing more months to the fallout from a loss. Especially as with all the years of trying and IVF I am now 37 with an AMH of 4.9pmol/l so really no time to lose. Let alone the emotional crapness it entails. Thanks for reading if you’ve made it this far! xx
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hi lovely, I only had one perfect looking 5AA blastocyst in my most recent round. We opted for testing due to both of our ages & because of recurrent chemical pregnancies & implantation issues naturally. We sadly found there was a chromosomal issue which had we gone ahead with a transfer may have been successful, but babies with this issue typically live less than a year. So for us, with only 1 embryo, even tho it was gutting, it was worth it for the future heartbreak it avoided, personally. I’m 42 tho for context.
Thank you so much. I’m so sorry to hear about this. I hope you are doing as okay as can be. That is certainly my fear. And I don’t want to risk a traumatic loss or even just another difficult 2WW without having some assurance the embryo is euploid. I think my gut feeling is to PGTA whatever number. Just hope we get some good quality ones with our new protocol now. Thanks again xx
I’ve been advised from the age of 40 (currently 41) to test all embryos (I’ve only managed to make 2 euploid and only get 1-2 at best per cycle). It’s definitely an individual decision but when the rates of genetic abnormalities are so high at this age it made sense to us to do it, to minimise heartbreak and time with increased miscarriage risk.
Thank you. I really think if we have many other losses (and by that I also mean a BFN post transfer as well as pregnancy loss) it may be what breaks my DH and he’ll say let’s stop so anything to minimise that is helpful. I really don’t want a prolonged recovery from miscarriage either or having to make a heartbreaking TFMR decision so again anything to try and minimise risk. So thank you I think I will push for testing any that are good enough quality to test and freeze. The clinic since I started IVF at 34 said I’m too young and seem to have maintained that even though I’m now 37. They are only agreeing to this because of my recurrent implantation failure. But I think it makes sense age wise now too.
All these decisions through IVF are so hard, well done for working your way through it. I don’t know the numbers for your age but if you google for aneuploidy risk by age you’ll find percentages which may help the decision as well. Good luck with it all and I hope you get some good news soon x
hello! Even if it is just one I would test. The reason is it helps further down the line! I am 43 my embryo was from when I was 40! I keep getting told my baby is at risk etc as an older mum. However, my tested embryo passed screening at 12 weeks for downs etc which saved me from having to make a tough decision if it has implanted and needed to terminated or if I had miscarried much later in the pregnancy. Each to their own but having that little bit of extra assurance made this process a little bit easier! Hope that helps!
given that you’ve had quite a few fail to implant I think it would be a good idea to test them regardless of the amount, that way if they are normal, you can probably look into other reasons as to why they have failed to implant.
I had two tested normal blastocysts fail to implant so I knew there was likely something else going on. So I had some more tests including immune stuff and was on different drugs the next time to address issues and it worked!
One thing to make sure is that your clinic would transfer ‘mosaic’ embryos if no ‘normal’ (most clinics do nowadays) because mosaic embryos have been shown to nearly always become ‘normal’. My 6 month old from the round that worked was a ‘mosaic’ embryo, so don’t be disheartened if you get any mosaics. But it’s good to know if embryos are ‘abnormal’ as it can avoid a lot of heartache (and money) by not transferring them.
Thank you so much. I have double checked and yes they do transfer mosaics. Thanks for sharing that, it’s so good to know.
I’ve had all the recurrent implantation failure/miscarriage testing already and have high NK cells and positive Antiphospholipid antibodies so hopefully with those meds on boards plus hopefully a normal embryo we will have better luck. My first pregnancy (the early/biochemical loss ) was post starting the meds but it was untested embryo, and also I hadn’t had my endo excision then.
3 or more for me personally- so I’ve never done it. I just transfer back instead same amount of time with the fresh then frozen and the same cost roughly. Jya my personal opinion though 🤗 xx
Thanks for sharing. I think now for me the cost is worth trying if possible to avoid future heartbreaks I think I’d rather know if what I’m transferring has good chance to work or not. But I have agonised over it! xx
Sorry to hear all you have been through. Last year aged 41 we ended with 3 x blastocysts after 3 back to back cycles. After a previous miscarriage from an untested cycle we were advised and keen to get our embryos tested this time. We were told to expect maybe 1 to be normal but were shocked when all 3 came back as viable! I’m currently 31 weeks pregnant and have felt reassured that chances of any defects are low given the PGTA testing which had been carried out.
This is a tough one. PGT-A testing is quite expensive. At my clinic, it was about 2k to test one, 2.5k to test two and 3k to test 3 or more. We had 11 embryos to test so, for us, it made financial sense to go for the testing. I think if I had 3 I would've been a little disappointed as I would've been paying the same as someone who was getting 20 tested. Not sure what your clinic's policy is. If it's the same as ours it might be worth embryo banking and sending them off at the same time for testing.
I will say now that it was worth it as I'm now 33 weeks pregnant with my little boy after multiple failed transfers and a chemical pregnancy.
Thank you! It’s is £2300 for up to 3 and then £2800 for up to 5, then an additional fee per embryo at our clinic. However we did look at batching and testing but the price for biopsy of frozen embryos was really expensive at our clinic. And we were nervous about the risk of Freeze-thaw-freeze-thaw. We will see how we go with this new stim protocol and how many eggs we get and then decide from there. We’ve sort of given ourselves a bottom line of 3 more stim cycles before we call it a day.
Congrats on your lovely news. I am so glad it worked out xx
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