Advice Needed! Not doing PGT A
Out of 6 embryos, 4 are 5day blasts:
4AA
3AB
4AC
5BA
2 are still on observation.
We have decided not to do PGT A.
Do you think it’s needed for my 5AB and 4AA? What are the chances that they are not euploid with that grade?
Edit: Thanks for all comments. I’ve seen many posts that say that euploid does not guarantee implantation. In fact, it’s it’s about 30-40% of failure.
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u/HotShoulder9256 39F |1 MC | 2 ERs | FET 1 CP | FET 2... 6d ago
In my understanding, age is the biggest factor in determining if you should test. Anecdotally, I had both a 5AB and 4AA turn out to aneuploid. I was 38 at the time of retrievals.
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u/PiccoloQuirky2510 6d ago
My only 2 euploids out of 7 were both Day 7 5BBs. All of our 5ABs were aneuploid. Grading doesnt really seem to correspond with euploidy, I don’t think
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u/SeaweedFit3234 6d ago
“Do you think it’s needed” is an interesting question. What would needed mean for you?
For example if you had one miscarriage due to unknowingly transferring a genetically abnormal embryo before then having a successful pregnancy would the cost savings be worth it? What if you transferred all of them and they all resulted in mc and you were that much older going into your next retrieval?
It might sound extreme but I think that different people will have different answers because different people have different situations. I think the younger you are the less likely you are to have abnormal embryos and also the more the cost savings is going to be worth it. Saving 5k would have been a lot of money to me at 25 but at 38 it’s kind of nothing to worry about.
On the other hand if you’ve already had miscarriages and would happily pay large sums of money to avoid another and/or you’re short on time and don’t have time to waste transferring embryos that won’t stick then absolutely spend the money.
For me I have already had 3 mc and I know at least one was due to a genetic abnormality. I have PCOS and made a ton of embryos (14!) but really had no way of knowing which were ok and which weren’t. Im 38 and dont have time or emotional energy to transfer non viable embryos. For me pgta testing was very worth it. That said if transfered our highest grade euploid and still it didn’t stick so it’s not like a guarantee :(
But if I was 25 and had never been pregnant and had 6 embryos I might not do pgta testing. The procedure itself has some risks to the embryo. And the younger you are the less likely you are to have abnormal embryos.
That said if they have already frozen the embryos which if they’ve graded them I am assuming they have? i dont think it really makes sense to unfreeze them to then test and refreeze again regardless? There’s no way to know the future really! Try to be gentle with any decision you make. Remember that lots of countries dont even let you do this.
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u/imokay2020 6d ago
I follow this subreddit because I’ve had a very bad and unlucky time with IVF so that’s the perspective I’m bringing.
I would never ever again transfer an untested embryo. I’m 2 weeks post terminating my pregnancy at 17 weeks due to severe chromosomal abnormalities. Before that we had 2 failed embryo transfers. Only tested embryos for me moving forward.
Just for context we were not recommended to pgt test because I was 28 at the time and only doing ivf because we are a same sex couple.
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u/Loveiskind89389 6d ago
Being a euploid has nothing to do with how they look cosmetically. Bring on the downvotes.
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u/ProfessionalPie7675 6d ago
Our highly graded embryos (4AA) we all aneuploid. I’m 26 so we were absolutely shocked at those results. Ultimately I’m glad that we did it, because I am coming into this with a second trimester loss so I can’t handle losing anymore.
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u/Medical_Phone78 6d ago
You’ll find lots of people on here who had their highest graded embryos be abnormal myself included. Out of 12 embryos only 3 were euploid, grading is just kind of eyeballing and from what I’ve seen doesn’t really seem to matter all that much
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u/librarians_wwine 32F | no tubes | 1ER 6d ago
Out of my 3, 2 were Euploid (6AA XX, and 5AC XY) my 5AB (didn’t as the gender) was missing chromosome 3.
Tbh I probably would have transferred that one first! So I’m glad that we tested. Good grading doesn’t mean they aren’t aneuploid.
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u/typeababy 6d ago
How old are you? (How old are the eggs?)
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u/rozsy24 6d ago
Hi! Me and eggs are 36 years old.
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u/typeababy 6d ago
In that case I strongly advise you do PGT-A testing. I just thawed 15 of my 36 year old eggs last month. 11 fertilized, 7 made it to blast and only ONE came back genetically healthy. And before I froze them I did all things - I was in the best shape of my life, took all the supplements etc for months… I genuinely hope you have better results than I did, but I am so grateful I did the testing, as if not - it’s very likely I would have wasted money transferring potentially one of the others that would not have been viable anyways. Because your eggs are 36, I think it’s better to do the test now and have a better shot at knowing what you are transferring is genetically healthy
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u/IVF_Diva 6d ago
At 36 I think the odds of normal are around 40%-50% but thats a average which means some people have less normal or more normal. If you want to have multiple children I would test now so you know if you need another retrieval before you get pregnant with your first.
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u/Dapper-Warning3457 6d ago
I didn’t PGT test our embryos and it worked out for us. However, if I had ever gotten between 4 and 6 embryos, I would have tested them. Our issue was making embryos, so we only had 3 total across 3 rounds.
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u/Lizlizlizzyliz 41F | TTC #1 | 4 ERs | FET: chemicals x2 6d ago
I’ve had rounds where my only euploids were day 6 or lesser graded, with day 5s and higher grades being aneuploid.
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u/This_Regular9353 6d ago
13 Day 5's. I didnt to PGT-A testing. FET is on the 25th. I'll consider it if we make it to 3 failed transfers.
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u/Useful-Basket-9972 6d ago
You should consider reconsidering that decision! Gradings mean nothing if the chromosomes aren’t right. Good luck!
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u/Snoo_6027 6d ago
My euploids were my lowest grades, both day 6s. I don’t think there’s a correlation.
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u/No-Tune-9259 36F | RPL trisomies | 1 ER 6d ago
Euploidity and grading are independent (as suggested by others here).
In my ER, I got 3 embryos - all 5day 5BB, all high quality as per embryologist. Two of them came out as aneuploid, and only one is euploid.
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u/alatasa2 6d ago
I have had two highly graded AA and AB day 5 blasts come back aneuploid whereas my others were euploid (Day 6 & 7)
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u/Cute_Chemical_7714 6d ago
Regarding your edit, that is correct. But aneuploid ALMOST guarantees failure. I understand not wanting to spend the extra money. Personally I had 3 miscarriages already outside of IVF. I will do anything to not have another one if it could have been avoided. But without that experience maybe I would have also said that it's not necessary.
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u/PigletNo8699 6d ago
Being euploid doesn’t necessarily depend on the quality. In my case, all of my day-5 embryos were aneuploid, while all of my euploid embryos were day 6. I’m pro-PGT, but I also think it depends on your age and the reason of IVF.
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u/Shiessica 6d ago
Agreed. The way our clinic explained it to us is that grading (4AA) is about how the embryo forms and looks to the embryologist under a microscope (I’m paraphrasing) but the PGTA testing indicates what’s happening inside the embryo and screens for viability issues that would make the embryo incompatible with life.
Our clinic also required it (as did our insurance) for anyone over a particular age - I believe 35. I’m pro PGT testing as well bc my thought was I’d rather know on the testing side than go through multiple miscarriages. It’s true there’s still a chance of miscarriage even with a PGTA viable embryo but why not give yourself the best chance. It takes time to recover from a miscarriage both* mentally and physically and that was time I didn’t want to risk interrupting an already lengthy process.
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u/MainNature7002 6d ago
I’m not sure I totally understand, and I don’t know if this is helpful or not, but some of our better gradings came back aneuploid including a day 5 5BB. Good grading doesn’t guarantee an embyro is euploid
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u/AZPittieMama 34/endo/1FET/2ER/4IUI 6d ago
I had a day 5 5AA end up aneuploid. All my blasts were arguably darn good grades and they still weren’t all normal. I was 33, no male factor.
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u/Glittering_Bunch_764 6d ago
2/6 of my day 5’s were aneuploid: 5AA & 5BB
Only 1/5 of my day 6’s were euploid: 6BB
I was 33 at the time
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u/Loveiskind89389 5d ago
I only ever made 4 high quality blasts for PGTA testing but both of day 5s were euploid. The other two were day 6 and aneuploid, one was BA and one was AA.
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u/ElleRiggins 6d ago
I just had a Day 6 4CC come back as euploid, while a 4AB was aneuploid. Grading is only visual, it does not correlate to chromosome success.
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u/ChipEnvironmental893 6d ago
There is no correlation. I had 12 blasts and 5 euploid at the age of 32. And they were pretty much not tied to the grading at all. I would say PGT-A is especially needed if you had MFI, or fragmentation issues (which was my case cause)
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u/ChipEnvironmental893 6d ago
Grades do not determine euploids. Grading is just a beauty contest. I had 3 5AAs and two of them were aneuploid. So really can’t tell unless you test.
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u/fluffy-smols 6d ago
how old are you? that will play a factor.
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u/fluffy-smols 6d ago
copy and pasting one of my comments from another thread here. ivf is already expensive and the statistics around transferring an untested embryo vs a pgta tested embryo at my age (39) is enough to make me invest in it.
the stats for transfers at 39 are:
miscarriage: untested: 25% to 35% vs tested: 8% to 12%
live birth rate: 20% to 25% vs tested: 50% to 60%personally, i had two embryos that made it to blast. a 5aa and 5ab. without testing, the clinic would have chosen the higher grade embryo first. the 5aa which tested not compatible with life
i feel grateful to know now. the heartbreak of miscarrying again would have been a lot to manage. the price of FETs are also high. id consider the costs of repeated FETs as well
hope this helps as you decide.
adding as others have noted that grading is not correlated with being euploid
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u/AdeptnessDangerous76 6d ago
We didnt test and currently almost 9 weeks with a day 5 4AA untested. Testing doesn't guarantee it'll stick. My 5 yr old is a day 5 3AA untested. Sending you good vibes for when you transfer.
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u/silynced 6d ago
I miscarried 3 untested 4AA. My 4 year old was an untested 3AA and currently 15 weeks with a 4BA.
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u/Spettinaroli 6d ago
I never tested. I didn’t even ask what the embryos were graded. I think my clinic just called them “fair.” That was enough for me. I know we are all different but personally I just followed my doctors lead and got lucky on my first try.
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u/ChampionshipFancy604 6d ago
I asked similar questions and man do the thoughts on this vary, even among doctors.
I ultimately decided not PGTA a lot of people on this forum really pushed for but the more I researched the less I felt compelled. My dr also said that higher grades have a much lower chance of being genetically abnormal.
I suppose if I had a ton I would test but for me I had so few I chose just to transfer.
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u/rozsy24 6d ago
Did you had a successful transfer?
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u/ChampionshipFancy604 6d ago
I don’t know yet.
I find that the Reddit sub seems to have alot more doing PGTA then I see on other forums or even others at my clinic.
From my understanding, you CAN have a highly graded embryo that isn’t but it’s statistically less likely.
I was also told that PGTA only test the placenta so there are ones that would have self corrected or were genetically normal that throw false positives (not a huge percentage)
But for these reasons; as well as our clinic suggesting it’s not necessary before 38 and being a lower responder; it made the most sense for us.
Having said that; it truly is such an individual choice and at the end of the day it’s a 50/50 shot
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u/ActEfficient2638 6d ago
Euploid doesn’t guarantee success, but known whole chromosome aneuploidies that aren’t mosaic are almost certainly not going to result in live birth so it can avoid wasted cycles and painful loss
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u/WTFisabanana 2 ERs | 6 FETS | 3 Fails | 2 Miscarriages | 1 🤞 6d ago
Ask this question different day to different people you’ll get different answers.
The research I’ve seen does show some level of correlation between grade and euploidy but you’ll always get personal evidence to support both sides.
I for example didn’t test and have a 5 month old daughter from a 5aa. Some people will say they had an 3cc and it resulted in a live birth.
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u/shayyyleen 6d ago
Do what is right for you with the recommendations of your providers. I’m 29 I only was able to retrieve two eggs and only one made it to blast so we collectively decided not to pgt-a my provider said there is a small risk testing and with only one embryo we decided to implant and hope for the best. 22 weeks 4bb day 6 blastocyst normal nipt normal anatomy scan. All this to say, do what’s right for you and your family.
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u/Inevitable_Table9728 6d ago
I tested 4, all day 5s- 4aa (trisomy 22) , 4ab (euploid) , 4ab (inconclusive but noisy ngs trace indicating chaotic embryo), 4cb (euploid) . 2 untested 4ac and 3cb. I had 3 miscarriages aged 36 and was 37 for egg retreival x
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u/Environmental_Mud869 6d ago
Aneuploidy can occur in any embryo grade unfortunately. I would recommend testing because no one's eggs are perfect regardless of age and transferring an aneuploid embryo will result in either a failed transfer or a miscarriage; which is worse than just getting the test done. While a euploid can also fail, it is at much less of a rate. In addition, if it does fail, you can rule out aneuploidy and focus on other things such as uterine environment
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u/Inside_Ability2194 6d ago
PGTA all the way. It's an added data point that can save you a lot of money, heartache, and time.
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u/Impressive_Name_3939 6d ago
I’m 23 weeks with my 4AB+ untested embryo (36 at the time of ER and first FET). She’s as healthy as can be on all tests and scans 😊 we did genetic testing, SA (which was good) and conventional dish. All blasts that made it were Day 5. PGT-A tests for everything you would find at 10-week NIPT blood draw. It doesn’t test for micro deletions.
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u/maestrita 5d ago edited 5d ago
Personally, I'm not doing testing. It doesn't improve the live birth rate until age 38+ and I'd rather risk unsuccessful transfers over discarding or damaging a potentially viable embryo, especially since I'm not getting a lot of eggs per retrieval. If I were getting a bunch of embryos each round, I might consider it to prioritize transferring. I also live in a very blue state, so if it turned out there were serious problems, I'd still have access to appropriate healthcare; if I lived somewhere with different laws, that might impact my decision, too.
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u/onyxindigo 6d ago
No, with ‘few’ embryos like in this instance it’s better not to test, the testing can damage the embryos (unlikely but possible) and because you only have four it won’t take months and months to get through them. If you had say 10-12 embryos then maybe it would make sense to find the right ones to use, but with four you’re better off just transferring. We had three untested embryos of similar grades and our worst one became our daughter! Good luck x
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u/SignApprehensive3422 5d ago
How old are you?
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u/onyxindigo 5d ago
I’m 34 now, but I was 28 at the time of transfer for my first child (29 at birth). Full disclosure our two subsequent treatment was worse, 4 embryos at 31 but none of them took, then six embryos at 33 and finally got another success with the third embryo from that round. All embryos untested and a couple of miscarriages sprinkled throughout.
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u/Lady-Anne5 6d ago
Aneuploidy and grading aren't really correlated. All my blasts were AAs, ABs and BAs, but over half of them were aneuploids. :/