PGD test same abnormality

Cindy123

PGD test same abnormality

Post by Cindy123 » Wed Jul 29, 2015 8:53 am

Hi Dr. Wisot
I went through an IVF cycle to freeze embryos. I'm 38. FSH 7.7 AMH 4.8. I had 16 follicles total. I'm not polycystic. We did the antagonist approach. Started with 175 Gonal-f and 150 Menopure. On day 5 my e2 went up to 1095 and my Dr dropped my Gonal-f to 150 and Menopure kept on 150. I had 11 days of stimulation and on day 10 my e2 went up to 5500. My follicle count was total of 26. Only 14 were mature We did the Lupron trigger shot. We retrieved 14 mature follicles. All 14 were fertilized. On day 6, six of them were full blasts and biopsied. Here is the PGD result:
4AB monosomy 21,
4AA normal,
4AA monosomy 22,
4AB trisomy 21, monosomy 22,
4BB monosomy 22,
4BC monosomy 21,
I had the Karyotype test and I am normal. I don't have the Chromosome 21, 22 karyotype.
The sperm is from a sperm bank and does not have it either. His Chromosome test was also normal.
What could this be? You had mentioned to a patient once that this could be a "processing error" . What is that? Could this be due to poor lab? Poor PGD testing? Too much stimulation medicine on my body? The rise on e2 to 6000 caused it?
Thank you
Cindy

Dr. Wisot
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Re: PGD test same abnormality

Post by Dr. Wisot » Wed Jul 29, 2015 3:22 pm

The medication dose or your high E2 should not cause that.

I don't know of anything in nature that would cause that.

The lab issue I was referring to was a dropped signal but with current technology to have so many of the embryos to experience the same monosomy would be unusual. One thought would be to re-biopsy those embryos and retest in the same or a different lab.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Cindy123

Re: PGD test same abnormality

Post by Cindy123 » Wed Jul 29, 2015 6:51 pm

Thank you for your reply Dr Wisot. We are going to rebiopsy and retest. We are in Los Angeles. What lab do you recommended for the PGD retest.
Thank you

Dr. Wisot
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Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: PGD test same abnormality

Post by Dr. Wisot » Wed Jul 29, 2015 7:11 pm

I would recommend Reprogenetics.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Cindy123

Re: PGD test same abnormality

Post by Cindy123 » Wed Jul 29, 2015 7:26 pm

Really appreciate that. I will let you know how it goes.

Dr. Wisot
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Posts: 1208
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Re: PGD test same abnormality

Post by Dr. Wisot » Wed Jul 29, 2015 10:13 pm

Please do. We all want to know the outcome.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Cindy123

Re: PGD test same abnormality

Post by Cindy123 » Wed Dec 09, 2015 8:56 pm

Dr. Wisot, sorry for my late reply. I had the biopsy done again but with genesis. The clinic was not contracted with reprogenetics. Here is the outcome again:
1c. AFRMO Trisomy 21
2c. Did not retest. This was the normal embryo
3c. AFRMO Trisomy 22
4c. AFP1B Trisomy 21 and Monosomy 22
5c. AFP1B Complex Abnormal
6c. AFP1B Monosomy for Chromosomes 21 and 7; Trisomy for chromosome 20
I'm still really confused.
Thanks
Cindy

Cindy123

Re: PGD test same abnormality

Post by Cindy123 » Wed Dec 09, 2015 10:26 pm

Dr Wisot
I also did a round of egg freezing and am doing another round of egg freezing soon. My new Dr. dropped my Stims to Gonal f 100 and menopure 150 (total 250). Even though the medication was less, this time my eggs grew faster and had to stimulate for only 10 days ( rather than 11). My e2 was still about 5500 on day 10. We got 17 full and mature follicles. We used Lupron trigger only.

On my upcoming egg freezing round my Dr. wants to do total of 225 stims. My Dr is debating on (gonal f 75 and menopure 150) versus (Gonal f 150 and menopure 75). What would you suggest?
My new FSH is 7.7, AMH 4.6 and estradiol 45. my age is almost 39. I'm not polycystic but my e2 rises to over 5000 on trigger day. My egg quality is also poor. As mentioned before I only had one normal embryo when I froze embryos.
Thank you for your guidance
Cindy

Dr. Wisot
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Posts: 1208
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Re: PGD test same abnormality

Post by Dr. Wisot » Thu Dec 10, 2015 8:17 am

I can give general guidance but I cannot give specific prescribing information here.

But realize that your problem does not sound like an "egg quality" problem but the problem of aneuploidy which is not thought to be related to the stimulation protocol.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

Cindy123

Re: PGD test same abnormality

Post by Cindy123 » Thu Dec 10, 2015 11:14 pm

Thank you Dr. Wisot!

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