Consultation re IVF - STICKING POINTS (Part 2)
Written by Arpee on September 23, 2008 – 11:42 pm -These topics are really the ones that have a lot of sticking points for me…
EGG/EMBRYO FREEZING
DrH also said that egg quality cannot be predicted and since I have old eggs, there is no point in egg freezing. They are able to assess the quality of the embryo through morphology to determine which will be transferred.
I don’t know if I picked up correctly on the discussion on Day 3 vs Day 5 transfer…
If there are only a few good Day 3 embryos, transfer is usually done on Day 3. If there are more than a few good Day 3 embryos, those can tested for PGD (preimplantation genetic diagnosis) or embryo screening.
DrH clarified that PGD is taken on the Day 3 embryo and results will be in for a Day 5 transfer. (So I am just realizing it now that if PGD is desired, that would automatically mean that it would be a Day 5 transfer - unless there is only a few good Day 3 embryo which forces a Day 3 transfer???)
On what is done to embryo and blasts that are not transferred - they are either frozen or discarded. They will freeze only those that are judged to have a high chance to survive the freeze/thaw. They give the blast up to Day 7 (which I suppose would be enough time/chance for the rest of the “lesser” blasts to survive before arresting) and will discard them.
Not sure if I captured that last statement accurately but that sounded a bit harsh… If I may quote from their clinic’s literature - “Only embryos that have fertilized abnormally, stopped dividing or have completely fragmented are discarded.” “Each embryo in our IVF laboratory is treated with the utmost care and respect…” DrH also mentioned that they are actually lean more leniently in judging the embryos to be frozen.
PGD OR EMBRYO SCREENING
DrH said that through PGD, they are able to determine if there are chromosomal abnormality (for 9 chromosome pairs only, not the 23 pairs) in all the embryos. This will isolate which embryos that have normal chromosomes from embryos that have abnormal chromosomes which lead to miscarriage. DrH also said that although PGD reduces the probability of miscarriage, it does not increase the pregnancy/live birth success rates.
The PGD is able to determine the gender of the embryo even at that point. (I read somewhere that there are some who practice gender selection using this method.)
DrH also said that as PGD will not be able to screen all chromosomes and I am of advanced maternal age, she recommends that if I do get pregnant, to have an amniocentesis for all the chromosomes since they cannot screen for Trisomy 21 (causes Downs syndrome) or Trisomy 17 and the like. (I don’t think I will do that since however the baby will be, I will accept. I will not terminate.)
I need to dig more into these. Please pray for wisdom and discernment that we make a decision that is according to God’s will.
Tags: amniocentesis, consultation, embryo, embryo freezing, embryo screening, freeze, IVF, PGD
Posted in Conversation, IVF, In Between Cycles, Infertility Learnings |
September 24th, 2008 at 9:21 am
Lots of luck making these decisions. I’ll pray for the Lord to give you strength and wisdom in this time.
I know it is a lot to digest. But I think you’ll get there.
September 24th, 2008 at 7:23 pm
You have it right on the day 3 vs day 5 thing. If there are only a few on day 3, the theory is that it’s better to get them back in your uterus as soon as possible. They may not be hearty enough to make it to day five, but would make it if in their natural environment. So it’s typically best to do a day 3 although with PGD it has to be day 5 and I think day 5 embryos tend to be stronger, so if there are a lot, they let them go to day 5 to get the strongest ones to transfer. At least that was my understanding of it when I asked.
(ICLW)
September 26th, 2008 at 6:02 pm
Echloe - I will be rooting for your IVF cycle!
Jenn - Thanks for the confirmation! I spent the last 2 days researching about PGD, FISH, PCR and CGH. I think I have a better understanding of those now.
October 14th, 2008 at 9:48 pm
Thanks for dropping by my website and leaving a comment too! Praying that the Lord provides great wisdom and clarity as you make these decisions. {{{hugs}}}