Journey through infertility ain’t easy nor cheap. Still, God is good…
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IVF#1 – Microarray on my Eggs

I learn a lot from the Internet and the women who have traveled this Infertility Path. So, when I hear about pre-implantation genetic screening (PGS), I now know that it could be the FISH (Fluorescent In-Situ Hybridization), CGH (Comparative Genome Hybridization) or Microarray (MA).

I really do not know a lot about the CGH methodology in details. I just knew …
- that a lot of women were successful in becoming pregnant when they had their embryos screened with CGH.
- that CGH tests 23 pairs of chromosomes vs the older FISH methodology of 9 pairs
- that CGH takes about the same amount of time to have the eggs/embryos tested (6 weeks)
- that CGH costs the same $$$ ($5000)

I also knew that…
- the lab the CCRM was using for the CGH (Reprogenetics, I suppose, based on the example report that was shown during the genetic counseling) recently had an issue that caused “no results”, and which they supposedly have fixed (and that CCRM has supposedly verified)
- in my conversation with ********, she relayed that a knowledgeable friend adviced her to do CGH (instead of Microarray (MA))

So I was thinking I would still go for CGH inspite and despite because …
- most of the press releases that CCRM has published highlights CGH, rather than MA
- most of the blog ladies mentioned the use of CGH, rather than MA

So when Danielle, the genetic counselor, said yesterday that the “scientist” want my eggs to be tested on the Microarray technique instead of CGH, I was taken aback. I thought all along and based on my conversation with Dr Sch last week that I did have an option to choose which method I preferred if I do not agree with their method of sending samples to whoever would have the faster turnaround.

Danielle said that although the CGH lab is up, they are sending all their samples to the MA labs. In a way, it does not make sense that they are sending all their current samples to the MA labs and I could only speculate on why

A good reason:
- The CGH lab is backed-up with lots of samples thus turnaround is long, thus necessitating CCRM to go to the MA lab for faster turn around.

Not so good reasons:
- CCRM is not confident that the CGH lab is really up and running. And CCRM does not really want to say it that way.
- CCRM is doing MA studies and are therefore, diverting all their samples to MA labs to build the population. (If so, they may not necessarily be doing it according to the best interest of the patient.)

We signed the MA consents this morning because we did want our ER to be delayed. We still do not know if MA would really be a better choice since I did not have time to research it since we knew about it only last Monday. I wish I had more time to research this.

So here I am less than 12 hours to my ER and I am looking for information on MA! And it turns out, the related literature are so highly technical that layman me can’t really understand it fully. Anyhow, just wanted to list them here (at the bottom) just in case some of you (specially those in the allied medical services) are able to read and understand them!

I have learned for a long time now (but not without much misery) that I can’t control everything. In fact, I can only control a few inconsequential things. So, I just put my trust on the Lord who has plans for me… to give me hope and a future.

For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future.” Jeremiah 29:11

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Microarray-related literature
Would you tell me what you get out of these literature???

Imprinted Gene Expression Analysis in Human Preimplantation Embryos: Biomarkers for Assessing Epigenetic Disruption
See how sample prep is done on page 5, top slide.
 
DNA Fingerprinting Identifies Viable IVF Embryos
-Published May 2008 and work in progress managed to “discover a cluster of genes known to be involved in important processes during embryo implantation that were expressed in the viable blastocysts. These genes regulate processes like cell adhesion, communication, metabolism, and responding to stimuli.”

Novel strategy with potential to identify developmentally competent IVF blastocysts
“RESULTS: Blastocyst biopsy did not appear to impair developmental competence. Comparative microarray analysis of cDNA from pooled ‘viable’ and ‘non-viable’ TE samples identified over 7000 transcripts expressed exclusively in ‘viable’ blastocysts. The most significant of these included transcripts involved in cell adhesion and cell communication, key processes that have been associated with mammalian implantation. DNA fingerprinting of three cohorts of sibling blastocysts identified those blastocyst(s) that produced term pregnancies. Submitted on October 11, 2007; resubmitted on February 27, 2008; accepted on March 18, 2008.”

Preimplantation Microarray Analysis (PMA) is a Robust technique that allows for Aneuploidy Screening of all 24 chromosomes with a lower Misdiagnosis rate than FISH based methodologies.
B. Levy1,2, O. Nahum1, M. Kamani2, K. Miller2, J. Su2, N. Treff2, R. Scott, Jr.2 1) Dept Pathology, Columbia University, New York, NY; 2) Reproductive Medicine Associates of New Jersey, Morristown, NJ.

Maternal age-related differential global expression profiles generated in human oocytes

Finite mixture model analysis of microarray expression data on samples of uncertain biological type with application to reproductive efficiency.

Reprogenetics: CGH Flyer

Reprogenetics: Microarray Flyer
It’s interesting how they call the microarray technology as “aCGH” for “array-based CGH”.

Polar Body Analysis kit

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BTW, as part of the Microarray procedure, we were required to:
- provide blood samples to the MA lab (some lab out there is going to have our genes in their library!)
- sign consents to biopsy, to participate in the MA research sponsored by another clinic, and to participate in one of the CCRM clinical studies.

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Alright, it’s about 20 minutes to midnight… I better go to sleep now.  I have an ER tomorrow!

3 comments

1 Polly { 03.18.09 at 12:43 am }

Are you on IVFC? I’m sure those ladies could fill you in quick style.

So excited that tomorrow is the big day and that God is in control!!!

2 MamaSoon { 03.18.09 at 3:09 pm }

Wishing you the best!!! I can’t wait to hear your update. Maybe Microarray is perfect for eggs over embryos. :-)

3 Arpee { 03.20.09 at 12:29 am }

Polly – what is IVFC?

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