1st IVF produced all embryos with chomosomal abnormalities

Dr. Wisot
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Dr. Wisot »

It is true that a woman's age is an important factor in the proportion of embryos that are chromosomally abnormal but women of all ages can produce abnormal embryos.
The "quality" of the biopsied sperm should not be a major issue as that does not usually affect the chromosomes of the sperm and that's really all you need from the sperm but it may be a factor in so few of your embryos getting to be quality blastocysts. So that may be why out of 14 embryos you barely had two you were able to test.

What they need to come up with is a strategy to get more of your embryos to make it to blastocyst so they can find the normal ones. And that is not easy. Another strategy if they can't would be to transfer early. We have had success in this situation with a day 2 transfer as those embryos may do better in your uterus than in the lab.

Arthur L. Wisot, M. D.
mary_ir
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by mary_ir »

first time I did IVF doctor on day 3 said if you want we can transfer it but all of them were poor quality and he said the chance of pregnancy is so low and I was afraid it end up to miscarriage. he mentioned incubator or human body wouldn't make that much difference.

I assume on day 2 transfer strategy there will not be any sort of genetic testing (test for abnormal chromosomes) so if I had transferred this embryo with good quality but abnormal chromosome or other ones would have ended up to an unhealthy kid? or the body automatically reject them and I end up with miscarriage?
Another question is if we go with fresh sperm versus frozen one this time, would it be better chance? they need to retrieve it from testicle
Dr. Wisot
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Dr. Wisot »

When we do a day 2 or 3 transfer there is no option for genetic testing. But if a couple's embryos do not have the energy to develop to a day 5 blastocyst there is no option for testing either.

The advantage of a day 2 transfer with poorer quality embryos is the effect of growing in the natural environment with other body cells present. We can simulate that in the lab (co-culture) but if we do that we cannot do PGS because the cells we use for the co-culture would confuse the testing.

The only real downside to not doing PGS for chromosomes is that a viable abnormality like Down Syndrome can implant and will not be discovered until the end of the first trimester leaving the only options to continue or terminate the pregnancy.

Arthur L. Wisot, M. D.
mary_ir
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by mary_ir »

Thanks doctor for quick response
Is there any difference if we use fresh sperm vs frozen this time? My husbands sperm was frozen in another lab for first IVF and we transferred them to this lab for second Cycle
Dr. Wisot
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Dr. Wisot »

With your history iut might be best to get a fresh specimen and let them choose which is the better specimen to use.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Evielam
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Evielam »

I just received the results for my pgs testing and all of my embryos came back abnormal. No embryos that would make a healthy baby. It's been the absolute worse day and night for me and my husband. I am 40 years old. My first retrieval was when I was 39. We have had done two rounds of retrievals- this last pgs testing was a combination of the frozen left from last time and this times fresh embryos- 7 altogether. Our first ivf cycle I was pregnant with twins from two embryos that they transferred without testing. We unfortunately lost them to a late miscarriage due to incompetent cervix. I have had a transabdominal cerclage put in since but How can it be that all of the rest were bad? We are in disbelief right now. Can pgs testing be wrong? Should we try for a third round of retrievals? The last retrieval gave us substantially less eggs than the first and none were normal. Is the fact that I did two stimulations affecting egg quality? Can the embryo abnormalities have anything to do with Sperm quality? Thanks for your help
Dr. Wisot
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Dr. Wisot »

Having had many patients go through this scenario I know how upset you are.

The stimulation is not thought to affect the chromosomes and neither does the sperm quality as we measure it. Of course if there is a error in the chromosomes of the sperm it will affect the embryos. Also the current methods of doing PGS are very reliable.

I wish I had an easy answer but you doctor who knows you can give you the best perspective on whether it's worth another try.

This is a difficult and frustrating problem and you are not the only one facing this issue.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
Sianyc
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Sianyc »

Hi,

I'm 39, and my partner is 41. We are doing IVF because my partner's sperm count is low (3 million). Doctor told me based on testing my ovary was working excellent. I also did genetic testing. I carry spinal muscular atrophy but my partner is ok so we are good there.

Retrieved 14 eggs, 13 were mature, and fertilized. 7 made it after a week and were sent for PGS. Just got the result, and all of them were abnormal.

We were devastated. When the doctor called me about the result, he wasn't able to explain whether the egg or sperm caused the problem. Now set up an in-person meeting w him on Monday and want to get as much as info as possible. Is it at all possible to tell whether it's the egg or sperm? Is it possible to test egg and sperm separately. We really don't want to just go for another cycle without understanding the root cause. The options would be very different depending on the cause. I also have 8 eggs frozen from 4 years ago.

I appreciate your help here. We would like to be prepared to ask the right questions on Monday, and see if we need consultation w an embryologist. Thx!
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by bubblebean »

I just wanted to share that I had all of my children naturally, with difficulty, and wanted to show you what you might have missed by letting go of all of the "abnormal embryos". I didn't know that I, or my husband have gonadal mosaicism, until our 3rd child was born. We found out that all 3 have chromosomal abnormalities, but that doesn't make them bad or wrong. I didn't get the chance to pick out a "normal embryo", I got what the good Lord wanted me to have. I am not here to judge or bash, just to show that science isn't always 100% correct, and an abnormal chromosome in your embryo might be the miracle baby that you have been hoping for. I understand the struggle, as we know we are supposed to have more children and know that we will be adopting embryos this time. I just wanted to share that abnormal can be beautiful, I would not trade them for anything even though sometimes life is tough.
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Dr. Wisot
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Re: 1st IVF produced all embryos with chomosomal abnormaliti

Post by Dr. Wisot »

I'm glad that this has worked out well for you.

You bring up an important point and we do not have all the answers. One of the big debates in the specialty is how to deal with mosaic embryos. It is now even a more difficult question as the current NextGen technology can pick up deletions in chromosomes as well as monosomies and trisomies. No one knows the consequences of these deletions, nor how a mosaic embryo will express itself.

Genetics is extremely complex and it will take a great deal more time to have the right answers in many of these difficult situations.

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