PGD or not PGD?

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hrapista

PGD or not PGD?

Post by hrapista » Tue Jun 21, 2011 12:08 pm

Hello,
I am getting ready to do a 2nd IVF for a 2nd child. The first IVF was successful at age 35. I am turning 40 in August and my doctor is recommending PGD because of my advanced maternal age. My husband and I are healthy and have no genetic defects running in our family but I've read several articles saying that PGD may increase chances of success because of the ability to test and select the highest quality embryos. I didn't see any posts on this subject on your message board for the last 4 years so I am wondering if your opinions have changed on the subject or if you still believe it actually decreases success rates by 1/3? I am leaning towards not doing it because of our successful IVF on the first try 5 years ago and no family history but I want to give ourselves the best chances possible for another successful IVF. I would appreciate any new insight.

Thanks so much,
Harriet Rapista

Dr. Wisot
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Re: PGD or not PGD?

Post by Dr. Wisot » Tue Jun 21, 2011 12:34 pm

I suggest you read the current recommendations on PGS for chromosomes which you can probably access on the American Society for Reproductive Medicine (ASRM) website. They basically do not recommend it in almost any situation, especially just for maternal age.

According to guidelines from the American Society for Reproductive Medicine, available evidence does not support the use of PGS for the following indications:

To improve live birth rates in patients with advanced maternal age
To improve live birth rates in patients with previous implantation failure
To improve live birth rates in patients with recurrent pregnancy loss
To reduce miscarriage rates in patients with recurrent pregnancy loss related to chromosomal abnormalities (aneuploidy)

It is clearer now than before that it reduces success rates. Most doctors who still are recommending it own their own PGD/PGS labs. Hmmm. I wonder why.

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

Fig

Re: PGD or not PGD?

Post by Fig » Mon Sep 29, 2014 6:22 pm

I am confused. I am about to begin my first IVF cycle at age 42 and have agreed (at the request of my Dr.) to do the PGD because of my age and an earlier pregnancy that terminated due to trisomy 18. Your statement, "it is clearer now than ever before that it reduces success rates" has me terrified. Do you own your own lab?

Dr. Wisot
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Re: PGD or not PGD?

Post by Dr. Wisot » Mon Sep 29, 2014 7:40 pm

That was ancient history in reproductive science.

Those ASRM recommendations were based on doing only up to 12 chromosomes on a three day embryo. Now we can do all the chromosomes in a biopsy of a 5 day embryo with much less chance for error or adverse effects of the biopsy.
Back then we did not recommend it except in rare circumstances. Now we use it more widely because of the advances I mentioned and much better freezing techniques.

So, fear not. :)

We do not own our own genetics lab and many of those who used to have given them up because they cannot keep up with the new technology.

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

Fig

Re: PGD or not PGD?

Post by Fig » Wed Oct 01, 2014 3:52 pm

Thank you for the clarification! I am feeling both relieved and hopeful!! :D

Dr. Wisot
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Re: PGD or not PGD?

Post by Dr. Wisot » Thu Oct 02, 2014 9:02 am

I'm glad. It's good to go into this with a positive attitude.

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

Delilah

Re: PGD or not PGD?

Post by Delilah » Sat Oct 11, 2014 10:09 am

I was told now it increases success for one reason, testing for extra chromosomes, by far the number one miscarriage Reason. I am still terrified and am trying without it first. Then I will do pgd prob for second if I've any frozen left

rabbit

Re: PGD or not PGD?

Post by rabbit » Tue Nov 18, 2014 5:22 pm

Can you test the embryo's after they are frozen? Do you need to use the embryo right away or can it be refrozen and then thawed a second time for the transfer?

Dr. Wisot
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Re: PGD or not PGD?

Post by Dr. Wisot » Tue Nov 18, 2014 7:13 pm

Frozen embryos can be thawed, biopsied and refrozen. Once we have the results they can be thawed for transfer.

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

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