PGT results

[Londongirl84]

Hello,

I’m hoping some of you are more experienced with understanding the results.

I had 5 blastocyst sent off to be tested and only 1 came back okay. I’ve spoken to the embryologist about what happened to the others and I’ve been told some were chaotic and others complex.

Does anyone know what this means and if they know/heard of anyone who has gone on to transfer such embryos? I’ve read on the “internet” that the embryo can correct itself but I don’t know if that’s true? I’ve also just read an article that someone pushed forward and transferred a chaotic embroyo and had a healthy baby. Again this is on the internet and I don’t know if it’s true or just made up tat.

Also has anyone re-biopsied chaotic / complex embroyos and had a different result?

Thank you! Xx

[CyclingAddict]

This is really interesting. I've never heard anyone refer to the embryos as 'choatic' or 'complex' after PGT-A testing. I sent 11 embryos off to be tested and 7 came back 'normal'. Of the four that didn't, 3 of them were missing chromosomes (this was detected in every cell they tested from these embryos). They told me that, even if they implanted, they would not have resulted in a live birth. The other one was a 80% mosaic. So 8/10 of its cells were abnormal. They said they do not recommend transferring an embryo where more than 20% of its cells are abnormal as the chances of it correcting itself are slim.

It is of course possible that results were not 100% accurate. But I suppose the questions I'd be asking the embryologist is, what do they mean by 'chaotic' and 'complex' - if they mean mosaic, what percentage of the cells in each embryo are abnormal? If it's under 20%, there may be a good chance it could correct itself.

Hope this helps! X

[Londongirl84 in reply to CyclingAddict]

Thank you for replying! Yes I’ve never heard of this either. So from what I understand chaotic is more chromosomes and complex was less. 😬 I think, I mean at a certain point this goes over my head. They are going to send me the full lab report. The issue I have is they were all 4AA/AB and now that I’ve read what I have I feel like I should re-biopsy them. They may not allow this, so was interested if anyone else has.

Yes they mentioned low mosaic can correct themselves so it sounded like this was something separate. X

Also congratulations on your 7! That’s amazing! Xx

[CyclingAddict in reply to Londongirl84]

Aw thank you! I remember one of our 4AAs came back as abnormal and some of the lower quality ones came back as normal. It really is a minefield!

If it's any consolation, we opted for PGT-A testing after 4 failed transfers and 1 chemical. I'm now 37 weeks pregnant with the first PGT-A tested embryo we transferred. So it really only takes one.

I have everything crossed for you that this one works out for you! X

[Londongirl84 in reply to CyclingAddict]

That’s amazing! Huge congrats! I’ve actually had two PGT tested embroyos fail this year from a previous round. Thank you I’m going to transfer next month and hopefully this one will stick as age is not on my side this time. 🤞🏼 xx

[hifer]

I have had euploid embryos, aneuploid (abnormal) and mosaics. I have transferred 2 mosaics and neither took but then many euploids haven't either so who knows. I don't think it's very common to transfer abnormal embryos in this country but I know it happens in the States. I would want to explore the terms chaotic and complex a bit more to know exactly what they mean.

I have had a tested embryo (that came back with no result) rebiopsied and it came back with a poor result and we still have that in the freezer. It is a very poor quality but it survived the thaw and refreeze so who knows. x

[Londongirl84 in reply to hifer]

Thank you for replying! Yes I think you are right with not transferring in the U.K. I mean as it stands I can’t use those embroyos so maybe it’s just worth paying the money to rebiopsy and see if there is a change. Pretty sure I will be told no. X

[Swimming87]

Worth getting a hold of the full report where appropriate and less confusing terminology will be used. Keeping all my fingers crossed for you xx

[GH1986]

I think the embryologist could be a bit clearer with you- perhaps you could ask them for more info. The below leaflet might be helpful:

igenomix.ca/wp-content/uplo...

My understanding is that you can have complex aneuploids, chaotic aneuploids, complex mosaics and chaotic mosaics. I think complex can have 3 or more chromosomal abnormalities (ie 3 or more chromosomal abnormalities affecting all the cells tested for complex aneuploids or 3 or more different chromosomal abnormalities affecting a percentage of the cells biopsied for mosaics). Chaotic is the same but 6 or more chromosomal abnormalities.

I tested 8, had 3 abnormal. 2 were monosomy aneuploids where all the cells biopsied missed or gained one chromosome. The other was complex aneuploidy meaning that there were 3 or more chromosomal abnormalities affecting all the cells biopsied.

Hope that makes sense!

PGTA is still quite controversial for a number of reasons so you might want to discuss with your clinic if they would consider transferring non euploids.

Xxx

[DancingQu33n in reply to GH1986]

Thanks for sharing the link. We’ve been advised to do PGTA after 3 failed transfers and feel quite nervous and unsure about it. This has helped to answer a few things I’ve had going round my mind. X

[Wishinandahopin]

hi lovely, did they say whether the chaotic or complex were ‘aneuploid’ or ‘mosaic’. If mosaic then they have a chance, if aneuploid then the chance is extremely slim (but not impossible).

You should ask your clinic to show you the results too- ie ‘-7(mos)’ or ‘+21,+6’ etc etc if they have a (mos) then they are mosaic. If they look like ‘dup(12)(pter-p 11.21(mos)’ then these are segmental.

I think complex and chaotic is when there are more than one chromosome missing/gained. Sometimes this is a testing error and so may be worth a retest.

That said they could all be aneuploid and if so then being complex aneuploid is v unlikely to work. If mosaic then you have a chance.

My son is a mosaic segmental (the most likely mosaic to take) and I have had testing done on 8 embryos over two rounds so fell down a rabbit hole with it all the first time so feel very knowledgeable about it now! So am happy to help if you have any questions etc! Also the Facebook group ‘my perfect mosaic embryo’ is v helpful too.

Good luck!

[Lelo3479]

Hi, Sorry to hear about your 4 embryo's, I haven't heard about the chaotic and complex classifications, I will have a research. But have researched about, euploid, aneuploid and mosaic. I hope your euploid transfers and implants well🙏❤️💐.

Yes it's true the embryo can 'eject' chromasommally abnormal cells. So mosaic can become euploid. That's why they use percentage of mosaicism to assess whether to transfer them or not. As too high a percentage of mosaicism, say 80% aneuploid only 20% euploid, means the embryo couldn't get rid of 80% of its cells, so a high likelyhood of a foetus with chromasome issues.

I've attached a screenshot from EmbryoMan, it's a good visual indicator on how some tests may not be completely representative of the embryo make up. Essentially, if the cells taken from a Mosaic embryo, come from an area where only euploid or aneuploid are present, then the embryo will be classed only as euploid or aneuploid. When in fact they're mosaic. The issue is the aneuploid classification, as clinics won't allow you to transfer these when they may be perfectly OK.

Another issue is they only take cells from the trophectoderm, which becomes the placenta. The inner cell mass becomes the foetus so the foetus may be fine and only the trophectoderm identified as aneuploid/euploid/mosaic.

Conversely, the trophectoderm can be euploid and inner cell mass aneuploid, resulting in a miscarriage due to chromasomal issues or live birth of baby with chromasomal issues.

PGT-A is really helpful, but not always accurate. Best wishes x

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[Axel131]

So what GH1986 said is correct re the classification of complex abnormal versus chaotic. Do get the full report from the lab and that will give you the specifics. In the meantime the Facebook group PGS/PGTA abnormal Embryo support has a lot of information on there. I think 2 women on it have had healthy babies from chaotic embryos so look it up and I'm sure they'll be happy to answer your questions.