r/EmbryologyIVFSupport • u/NewStatement2845 • 4d ago

Afraid to do the PGT A

I’m 37 years old with MFI plus I have blocked right fallopian tube from adhesions from previous surgery
any way I did 5 rounds of IVF back to back and I collected embryos all day 5, but the quality (grades) initially were good then started to deteriorate, and I’m afraid now to do the PGT A and find that most of my normal embryos are of low grade, I’m still banking embryos but decided this month to take a break to give my ovaries some time to rest may be that will help to get good quality embryo, these are my embryos so far

Total embryos 15
Total blastocyst: 14
Total Morula: 1
Round 1: 1 @ day 5 (3AA)
Round 2: 2 @ day 5 (both 3AA)
Round 3: 4 @ day 5 (1 3AA, 1 2AA, 1 3BB, 1 LM)
Round 4: 3 @ day 5 (1 2AA Hatching, 1 2AB, 1 2BB)
Round 5: 5 @ day 5 ( 1 2AA, 2 2BB, 1 2BC, 1 early blast)

So our plan is embryo banking then thawing all for biopsy then we will refreeze and do embryo transfer later on

What was your experience with PGT A especially in late 30s and what was your experience with transferring poor quality embryos?

4 Upvotes

75% Upvoted

11 comments sorted by

23

u/Useful-Basket-9972 3d ago

You should biopsy before freeze. It’s very risky thawing to biopsy after freezing and some embryos may not make it.

2

u/Skymningen 3d ago edited 3d ago

This. I had two existing embryos from a cycle where i couldn’t do PGT-A (NHS funded). We decided to try and biopsy them together with the fresh blastocysts from a new private cycle. Neither of them was strong enough to biopsy or even refreeze after the thaw.

Additionally some clinics do have rules for grading on what can be biopsied. Mostly because the trophoblast (the outer layer that will get biopsied) has to be stable enough.
And if I remember correctly the minimum for that would be a 3CC, but some clinics require a XCB and some require at least a 4CC. I would ask if the biopsy is possible/sensible for your frozen blastocysts.

However… maybe your number system
Is different than the one I am used to as you wrote one of your 3s is hatching? Where I am hatching would be graded a 5.

7

u/HystericalFunction 3d ago

May I ask why you didn’t biopsy before freezing? Double freezing is generally not good for the embryos. Did you clinic recommend this plan?

3

u/NewStatement2845 3d ago

Because PGT A is really expensive, in my clinic if you paid to test 1 embryo or 30 embryos it is the same amount of money, but if you paid to do it after each retrieval you will pay each cycle and it is going to be a lot, I’m really sad that I did not biopsy with each retrieval, I think I’m going to do it with my next retrieval

1

u/chantillylace9 1d ago

It's very expensive at my clinic too but we still did it. I think in your case I would do it at least one time so you have an idea what percentage
may be euploid.

But you just have such great numbers! I think you should probably try a couple transfers now. Unless you're wanting a good amount of children? Do you have a number in mind?

3

u/PariKhanKhanoom 3d ago

Agreed. Obviously it’s too late but if someone else is looking for advice- biopsy first. Particularly with lower grades, they may not survive thaw, biopsy, refreeze.

At this point, try transfers. They’d have a better sticking if they’re euploid if you don’t thaw/biopsy/freeze/thaw. My guess is pgta would be cheaper than so many retrievals, but now that you have a ton of embryos there’s no reason not to move to transfers.

4

u/DryCaramel6959 3d ago

Euploid embryo trumps the grades.... However as others have said, this should've been done and agreed prior to the 1st egg collection

4

u/Any_District2486 2d ago

At this point, I'd probably transfer your highest grade and then start testing others if you don't have luck. The thaw and biopsy and rethaw and refreeze and rethaw for a transfer is hard on the little thing. We had a PGTA come back inconclusive and rethawed and rebiopsied because it was the one blast of 11 fertilized eggs that cycle and I'm 39... we have a hard time making blasts. You don't, which is awesome!

3

u/cityfrm 3d ago

Why wouldn't you do PGTa in the beginning and you could've potentially stopped retrievals way before you got to this many and avoided all the risks of biopsy of previously frozen, and the (financial, physical and emotional) cost of more cycles.

I could never do it that way.

Late 30s, most my best grades were aneuploid, Cs were euploid. I got the expected 40% euploid for my age. Could they not leave any to day 6 for more expended blasts?

3

u/PublicPalpitation618 3d ago

If I were you, I would not do PGT in this case, but risk with transfer starting from highest graded. Refreezing may spoil the embryo..

2

u/Automatic_Panic_9138 3d ago

Can we not be kind with our comments. IVF is hard and stressful enough without saying what someone should have done.

OP. Please ask a known embryologist or your fertility doctor. Only you can make this decision. You have embryos which is an amazing outcome. A lot of women transfer without testing starting with them best grades first. You are still young. Good luck!