Natera Update

[Dr. Potter]

Hello Everyone. I am sad to report that Natera will no longer be doing PGD for fresh transfers for the time being. This will be in effect 3/1/13 for most centers and 3/15/13 for a few special cases.

Natera will continue to offer PGD for day 5 all freeze specimens.

This change is being done for purely business reasons. Natera and myself still believe that we have the best PGD product on the market.

Natera has made a decision to focus the manpower that they have on the new Panorama test for the immediate future. As some of you are aware, Natera has launched Panorama, a non-invasive pre-natal diagnostic test that allows us to determine whether the child the patient is carrying is has one of the major aneuploidy syndromes and also whether it is a boy or girl (as well as paternity). Quite simply, the response to Panorama has been overwhelming and Natera has had to make the a decision use its available manpower to address this demand. In taking the fresh PGD testing off-line, Natera will be able to focus on servicing Panorama and a likely IPO over the year 2013. Natera remains committed to PGD and when fresh Natera PGD is relaunched, hopefully in 2014/15, we will be using sequencing technology along with our proprietary infomatics. This will allow very rapid turn around times and easily accommodate day 5 biopsies with fresh day 6 transfers or day 3 biopsies with day 5 transfers. I will be personally exploring the question as to whether we improve pregnancy rates using Natera and all freeze or aCGH with a day 6 transfer. This remains an open question and I intend to accumulate data on this matter and present it to the public as soon as I have sufficient data to present.

I will remain Laboratory Director for Natera for the immediate future until a suitable replacement can be found and we can transition to the new Director. The responsibilities of being Laboratory Director of what is rapidly becoming a very large company require more attention than I can manage and still practice medicine. I will remain Laboratory Director of the PGD division after this transition has been completed.

As for my practice, I will continue to offer Natera Day 5 biopsy on ‘all freeze’ cases but will be forced to transition to day 5/day 6 aCGH for all fresh cases. I am working with an aCGH laboratory to create a hybrid test that will improve accuracy with the Y chromosome and other small chromosomes. For cases currently in process at my center, we will continue to use the Natera day 3 with day 5 transfer for all cases biopsied on or before 3/15/13. All cases beyond that will be aCGH day 5 biopsy and day 6 transfer.

[nuthinbutpink]

Thank you for posting.

I have seen Dr Sher's blog and he has posted about aCGH day 5 still being aCGH and not mCGH and the "accuracy" is the same as day 3, which we have seen opposites from so how can we be sure that day 5 aCGH is okay for GS? Is there any way to know for sure that it will not miss the Y chromosome?

I do hope that aCGH day 5/fresh 6 can work and of course be 100% accurate minus human error because for those that travel long distances, this is difficult to take to say the least.

I hope you are able to make a day 5 test and day 6 transfer work for them somehow.

[Hoping4Kaylani]

I have also read that Natera's fees for a day 5 biopsy with a "freeze all" are lower than a day 3 biopsy with a day 5 fresh transfer. Will HRC consider lowering this cost to compensate for the added FET cycle cost?

[yearningyoyo]

Hi nuthinbutpink,

I am hoping you can help me wrap my head around what this means for those of us travelling from overseas.

Based on my research around this site it would appear that best chances of success then going forward would be to do a FET with day 5 Natera.

Obviously that will mean 2 trips to the US (assuming you get at least one embryo to freeze). Question then becomes - how long would you need to stay for each visit?

On first visit I presume you could leave US as soon as egg retrieval was done and just receive your results by phone/email? So how many days in US before egg retrieval? And then return on second trip just for FET. How many days stay would that require?

2 trips will be more expensive but potentially more manageable in terms of being away from the kids for 2 shorter periods of time and reduces time DH has to be away from work.

Would really appreciate your thoughts or indeed anyone else's on this,

thanks

[annec]

hi, i am really new to all this and am wondering, in order to keep it relatively non invasive, would it be possible to use Microsort & Panorama in order to select gender and detect genetic anomalies? how accurate would the results be?

[purpledream]

I'm not Dr.Potter, but Microsort is long gone from the US, they don't do it anymore. I have never heard of Panorama, it must be some European test, they have different ones here.

[nuthinbutpink]

hi, i am really new to all this and am wondering, in order to keep it relatively non invasive, would it be possible to use Microsort & Panorama in order to select gender and detect genetic anomalies? how accurate would the results be?
Panorama is a blood test done on the mother after you are pregnant. The only way to verify gender prior to implantation is to biopsy the embryo. You have to get material from the embryo itself in order to verify gender outside of the womb prior to implantation.

Microsort is available in Mexico but not the US. There's really no such thing as non-invasive if you want a guarantee. You can do IVF and MS only but you still need IVF.

[nuthinbutpink]

Hi nuthinbutpink,

I am hoping you can help me wrap my head around what this means for those of us travelling from overseas.

Based on my research around this site it would appear that best chances of success then going forward would be to do a FET with day 5 Natera.

Obviously that will mean 2 trips to the US (assuming you get at least one embryo to freeze). Question then becomes - how long would you need to stay for each visit?

On first visit I presume you could leave US as soon as egg retrieval was done and just receive your results by phone/email? So how many days in US before egg retrieval? And then return on second trip just for FET. How many days stay would that require?

2 trips will be more expensive but potentially more manageable in terms of being away from the kids for 2 shorter periods of time and reduces time DH has to be away from work.

Would really appreciate your thoughts or indeed anyone else's on this,

thanks
You can do one trip with day 5 aCGH and a fresh transfer.

[Dr. Potter]

You can do one trip with day 5 aCGH and a fresh transfer.
We will have a new test, GenderSure, available through Blastogen, starting in May. This test is done with a day 4 biopsy. aCGH is done as well as extra PCR specific to the sex chromosomes. The GenderSure test alleviates concerns regarding day 6 transfer and also provides 100% certainty for gender. I have been working with Barry Behr, PhD, Blastogen's scientific director on this test and we are very excited with our results so far. More details, ordering info and price to follow.

[vickyaust]

Thanks Dr Potter.
For those of us already pregnant with aCGH babies, can you please clarify the success of aCGH. There has been 95% quoted here as success, however I was thinking it was 99.9%.

[glory]

Hi Dr Potter, most clinics are going ahead with day 5 biopsy as standard for PGD because of the benefits seen, why has your clinic gone with a day 4 biopsy? I thought the compacting embryo stage was not a good one in which to biopsy and taking cells from the trophectoderm only will give a better result?

Would day 4 CGH be similar to day 3 (in that there is more chance of gender error) or closer to the accuracy of day 5 CGH?

Your day 5 CGH results with day 6 transfer have been phenomenol :) I understand you want to make the gender 100%, but do you expect the success to be as good with this testing as with day 5 testing?

Thank you

[annec]

We will have a new test, GenderSure, available through Blastogen, starting in May. This test is done with a day 4 biopsy. aCGH is done as well as extra PCR specific to the sex chromosomes. The GenderSure test alleviates concerns regarding day 6 transfer and also provides 100% certainty for gender. I have been working with Barry Behr, PhD, Blastogen's scientific director on this test and we are very excited with our results so far. More details, ordering info and price to follow.


is this test available with teh full chromosome testing pannel? i am new so the answer might already be posted, if so, sorry :)

[Dr. Potter]

I'm not Dr.Potter, but Microsort is long gone from the US, they don't do it anymore. I have never heard of Panorama, it must be some European test, they have different ones here.all true

[Dr. Potter]

Hi Dr Potter, most clinics are going ahead with day 5 biopsy as standard for PGD because of the benefits seen, why has your clinic gone with a day 4 biopsy? I thought the compacting embryo stage was not a good one in which to biopsy and taking cells from the trophectoderm only will give a better result?

Would day 4 CGH be similar to day 3 (in that there is more chance of gender error) or closer to the accuracy of day 5 CGH?

Your day 5 CGH results with day 6 transfer have been phenomenol :) I understand you want to make the gender 100%, but do you expect the success to be as good with this testing as with day 5 testing?

Thank youWe are getting even better results with the day 4 biopsy. There is a small advantage to a day 5 transfer, especially when we are dealing with high responders. We will offer the GenderSure to patients whether we are planning a day 4 or day 5 biopsy as it adds accuracy to gender and allow us to offer a full refund for any case that results in a documented gender opposite. I am getting an 82% pregnancy rate so for in 2013 transferring 1.41 embryos on average. That means I am transferring 1 embryo more often than two to get these rates. The remaining 18% is my focus. If we can get a few more pregnancies doing day 4, we believe that we can get this rate up to 90% and the number of embryos transferred per case closer to 1.0. The day 5 biopsy/day 6 transfer is always an option that can be selected by my patients. The results have been tremendous so you will not get any push back from us if that is your choice. As we get more data, I will report it here. The GenderSure resulted in a 100% gender certainty using a validation protocol with just a single cell. That means we could use it for day 3 if we wanted to. The day 4 biopsy gives us more cells and that results in fewer 'no results' and also reduces the effect of mosaics. We are pushing the envelop to get to that other 18% and get closer to our ideal of near certainty in both pregnancy rate and gender calls.

[Mumof3girls]

Dr Potter do you know if Natera will be available in 2014 with fresh transfer? I would prefer to have a fresh transfer because we are travelling from Australia but I would also prefer Natera as it gives much more information on embryos.

[lisvna]

As far as I know Natera is only with a FET. A fresh transfer is possible with aCGH testing.

[Mumof3girls]

As far as I know Natera is only with a FET. A fresh transfer is possible with aCGH testing.

I know Natera is no longer available with a fresh transfer but Dr Potter said in his first post that when Natera is re launched in 2014/2015 it will be possible for fresh transfer again. Is there a re launch soon? I'm sure that if people were given the option of using Natera with fresh transfer many would love to use it.

[lisvna]

I know Natera is no longer available with a fresh transfer but Dr Potter said in his first post that when Natera is re launched in 2014/2015 it will be possible for fresh transfer again. Is there a re launch soon? I'm sure that if people were given the option of using Natera with fresh transfer many would love to use it.

Aha oke, didn't know that. Curious too now!

[willtherebe4]

Following too, great point Mumof3 :)

[emmake]

Good question. Looking forward to dr Potter's reply.

[willtherebe4]

No pressure Dr Potter lol ;)

[Mumof3girls]

Bump!