PGS Help

Okay, IVF ladies, I need your help.  When my husband & I did our fresh cycle back in early 2014, we opted out of PGS (Pre-Implantation Genetic Screening) testing of our embryos. At the time, we did not think we would need it. On paper we looked great- young, healthy, no losses, no medical histories, MF diagnosis…pretty much by the textbook for success.  

But after going through 3 miscarriages and 5 embryos, neither my husband or I feel overally comfortable transferring one of our remaining 3 embies without having them genetically tested.  Of course, every mother wishes for a healthy child, but I must be honest with you- my fear now is much greater than anytime I was ever pregnant before.  

So, we discussed the possibility of PGS testing our remaining frosties with our RE yesterday.  I guess it can be done, but it is not as commonly done or recommended as doing it on fresh embies (makes sense).  

Basically, they would have to be thawed, tested, refrozen, and then thawed again to be transferred. I keep thinking of taking meat out of the freezer, thawing it, then refreezing it, and then thawing it again….ehhhh.  IDK.

But heres the thing-my RE and embryologist seem to think that whether or not they could survive this double feeeze/thaw would be mainly based on their quality to begin with. For example, really strong embryos will make it regardless of the double freeze whereas the others wouldnt.  

I am curious if any of you ladies have successfully or unsuccessfully tried PGS on your frosties (not fresh)? Please share! 

The dilemma I am faced with is what if they tell us all 3 are genetically unhealthy? What will we do then? Thats a tough thing to consider. Would we

  • Still transfer? Doesnt seem to make sense, why even test in the first place then? 
  • Donate to science?
  • Dispose? Seems kind of selfish & cruel in a way
  • Go through another fresh cycle? So much more money, drugs, which is really all just strain on my body
  • Give up on IVF altogether? 

My mind races thinking about all this.  

  • Do we just chance it like we have the past 3 transfers and pray for the best? 
  • Forget the PGS?
  • What if we get a ton of embryos from doing another fresh cycle? It might sound crazy, but we do not want this.  I know most people dont usually say this, its the other way around. But we got 8 day 6 blasts our first time, and I am not looking for 8 more in all honesty. Maybe it is what we have gone through, I dont know…I am just being honest. If these 3 remaining are good, that is more than enough for us (if my uterus cooperates).

My RE did point out that if all 3 of the embryos we have now come back genetically unhealthy, and we know we would want to go through another fresh cycle for more embryos, then we should do the fresh cycle and then test all of those embryos and the frozen embryos we have now at the same time.  

She says this only because of cost for us.  It is a flat fee to do PGS-as many embryos as you want can be tested, but the testing has to be all at the same time.  For example, if we test these 3 now, it will not include any testing down the road. God forbid they are unhealthy and we still want to move forward, we would have to pay the same price to test all of those new embies.

Decisions, decisions…

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25 thoughts on “PGS Help

  1. While we only did PGS on fresh embryos (1 of 5 normal), we still do have one untested embryo on ice. With one it wasn’t necessarily worth it to us, especially considering how my insurance works, but with 3 I think I would have given it a shot. Once you get into the PGS world it’s a double-edged sword. Knowing makes you question a lot of things, but it also gives you peace of mind. Peace to you that you make the best decision for you and for the best outcome.

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    • Thank you for sharing your experience. I can see how it would be like opening up a can of worms. Its so unfair it costs so much, im leaning towards that we cant afford another fresh cycle right now. That means we could possibly pull of paying to test just these 3. I guess we will see!

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  2. Oh man! That’s so tricky! You should check how many embryos they cover in a test cycle – I know at our clinic they test up to eight embryos (with an extra having a token fee added). Because I’m a poor responder, we didn’t get as many as we thought we would – so we did an extra round to bring up the number of embryos we have for testing to give ourselves the best chance (and to keep the costs down for any subsequent rounds we’d want to do – PGS is expensive!).

    I’m the kind of person who likes to play safe (wherever possible) so I’d probably go with your dr in doing a fresh cycle and then testing, but truthfully you could also play the odds. I can’t remember which study I read it from, but the rate for normal vs abnormal is about 40-50% are normal for women under 35. If the problem is chromosomal quality, and if everything else is fine then you could lean on the side of probability – as your the first 5 were chromosomally abnormal, then of the eight the last three could be normal. It’s a tricky thing to do, really. Gambling with babies when the stakes are so high!

    Hope you guys figure out what option is best for you!

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    • Thank you for the info! Our clinic tests an unlimited amount as long as its all at the same time, so thats nice. It really sucks, because we know at least 1 of the embryos I miscarried at almost 10 weeks was chromosomally normal. Ugh. We do think the loss was due to a uterine abnormality now. So who knows what the others ones we lost were like, we were not able to test them all. It is totally like gambling…which i hate!

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  3. This is tough. I think I would probably do another fresh cycle and test them all. I say this because I think if you are going to go through that stress of testing embryos it is smart to go in with your best odds and guns blazing. Also- have you thought about a lighter dose of meds to get fewer eggs. I do think testing is the way to go. It gives you more information and better odds at transfer. Good luck with your decision. Sounds like you have some good possible options.

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    • I hadnt really thought of the lighter dose of meds until you brought it up! Thank you for reminding me they have things like mini-stims and such. Its been years since I did a fresh cycle so I had forgotten. This is an idea if we decide to go the fresh route!

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  4. Such a tough situation. We were kind of in the same boat as you. We had 6 blasts make it to day 5. Like you, we thought our only problem was my fallopian tube, so we opted out of PGS testing. We had a a chemical with our fresh and then failed FET transferring 2. It was recommended that before transferring the final 2 embryos, that we do a whole other round of IVF, but we need time to save up another $20k, plus we weren’t emotionally ready. So, as you probably know, we are transferring our last two without PGS testing, but then if this last round doesn’t work, we will move forward with PGS testing the next time. But since you have 3…. that is a little more tough. If I were in your shoes, I may do another IVF round and test them all at the same time….

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    • Thank you for sharing! Yea, we are definetly in a similar situation. We dont have the cash right now for another fresh IVF cycle unfortunately. We have been talking and it seems like we will either have to just test these, not test these, or eventually do a fresh cycle and test those too. I hate how money plays a factor into something like this.

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      • I agree. What I hate even more is that if we lived in a place like Massachusetts, or worked at a place like Amazon or Microsoft (those are places around me that provide IVF insurance) then money wouldn’t be a factor. I hate how depending on where you live could make all the difference as to what you can do. My hubby and I have actually seriously looked into states that provide coverage and talked about moving there. Good luck to whichever you decide. Thoughts are with you!

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  5. This is a very personal decision, so I’ll give you my opinion, but totally respect your choice. My friend Krystal opted to thaw and test after her past losses. I think it’s a good protection for you. I totally support whatever you decide.

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  6. My thoughts: You cannot transfer genetically abnormal embryos. It would be a waste of time, heartache, and no clinic will do it. So if all your embies are abnormal or do not survive the thaw, then you will have no transfer and you will need to prepare for a fresh cycle. That said, it seems to me your issue has been more body-based than embryo-based? You make lots of blasts and have got pregnant a number of times. Call me crazy, but I’m not convinced PGS is necessary for someone who seems to have good quality eggs. I note you had one of your losses tested for chromosomal abnormalites, and it was normal. Personally, I would treat the uterine issues agressively and then thaw your three embryos with the intention to transfer 2. If you do a fresh cycle, PGS could be worth it. I don’t think IN YOUR CASE PGS is worth it for 3 embryos. It’s a lot of money. In most cases, genetically abnormal embryos just won’t implant anyway. Good luck with whatever you choose.

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    • Such good points Emma! Yes, we feel my past losses were all based on uterine issues, not embryo quality. In fact, all of our embryos (by looks) were graded extremely well! I make nice eggs and got pregnant every time like you said too. I guess im just starting to let my mind race and think what if after all these uterine issues are fixed, the last 3 embryos are by chance unhealthy or something! Like we have used up all the healthy ones. I know, probably ridiculous to think this way. I really appreciate you seeing this rationally for me. I think you are most likely right my friend. Again, thank you for taking such close note of everything.

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  7. I don’t have experience with PGS, other than considering it for ourselves, so I can’t provide a good advice. But I tend to agree with Emma’s comment above. Do you really think chromosomal abnormalities is what’s stopping you from carrying to term? I guess I would gamble and thaw and transfer 2, if I were you. But I completely understand how difficult this decision is, and how you’d need to be ‘ready’ for another possible loss. Hope you can figure out what’s right for you.

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  8. I was in a similar situation.

    My clinic (which sends PGS to CCRM) said they absolutely do not test frozen embryos and they will never freeze them twice. If I wanted to do that, I would have to transfer them to another clinic. They would not thaw and refreeze, without extreme circumstances like a newly diagnosed fatal chromosone issue or something.

    There is very, very little data on it because it is done so rarely and is not good practice. (this is a decent explanation http://fertilitylabinsider.com/2013/10/q-from-u-is-thawing-and-refreezing-embryos-harmful-to-the-embryo/)
    If your lab is doing this, you need to ask a bunch of questions. If they are doing this, they should have some numbers. But, the fact that this is even an option would make me question the quality of your lab. With uterine issues, I’m not even sure why this is on the table for you.

    I ended up doing a fresh cycle, and 6/7 tested normal.

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