Miscarried 1st time doing PGD. Many eggs fertilized but poor embryoquality

[Mollo]

Dear Dr. Potter,

My dh and I have just finnished our first attempt using IVF/ICSI/PGD for a girl. I am 26 and he is 30 years old. We have two boys that we conceived normally after 1 and 2 months trying. We did a fresh ET.

We got pregnant, bud sadly we missed it a week atfer BFP

Now we are wondering what could have been different. The results wasnt soo good.

Here it is:
We were on a short protocol, using 225ie menopur for 10 days, cetrotide for 2 days and then ovitrelle. After ER I startet on 800 Utrogestan a day.

The total number of eggs were 25, and 24 were mature. 21 fertilized.
Day 1: 20x2PN, 3x0/1, 2xdeg
Day 2: 4x4, 8x3, 6x2, 2xo
Day 3: 2x8, 2x6, 1x5, 6x4, 8x3, 2x2
Day 5: Normal genetic 1xHB (boy), 1xEB (boy), 1xCM (girl)

Only 6 was good enough for PGD, and out of them only 3 came out normal. We transferred the Compact Morula girl, and got pregnant. As told I lost it 1 weak after BFP. We are soo devastated.

What could have been different? Before starting stimming, I didnt take any pretests exept from bloodtests, and two ultrascans when using menopur.

Could there be something wrong with me? Something I should test for?

The doctor told me that if this didnt work we could try self correction(?). Because the embryos could have been normal even do they came out abnormal. We have freezed dowm my dh sperm, so I can travel down alone first for ER, and then they take cells from the embryos on day 5, freeze them and I come back only if there is a normal girl. This seemes as a pretty good solution, but what are the chances here? I guess this is called aCGH? Do the embryos have do be at the blastocyst stage at day 5? I have heard that the girl are a bit slower growing?

I really hope to get some tips from you!

(The second paccage of Menopur was 6 month old. BB February 2013. I didnt notice before I had used it for 3-4 days). Do you think that this have cause the poor embryo quality?

Thank you

[Mollo]

Can you please look here Dr.p?

This is the results from dh SA:

Cons: 151 million
Motility: 64 %
Progr. Motility: 13 (normal over 32)
Norm. Morphology: 5 (normal over 4)

Do you think this could have something to do with why we lost so many embryos on day 3?

We was told that the SA is normal, but a little slight progr. motility. He have a huge cons. though, so I guess there must be enough?

We were using ICSI.

[Mollo]

Bump

[Dr. Potter]

Dear Dr. Potter,

My dh and I have just finnished our first attempt using IVF/ICSI/PGD for a girl. I am 26 and he is 30 years old. We have two boys that we conceived normally after 1 and 2 months trying. We did a fresh ET.

We got pregnant, bud sadly we missed it a week atfer BFP

Now we are wondering what could have been different. The results wasnt soo good.

Here it is:
We were on a short protocol, using 225ie menopur for 10 days, cetrotide for 2 days and then ovitrelle. After ER I startet on 800 Utrogestan a day.

The total number of eggs were 25, and 24 were mature. 21 fertilized.
Day 1: 20x2PN, 3x0/1, 2xdeg
Day 2: 4x4, 8x3, 6x2, 2xo
Day 3: 2x8, 2x6, 1x5, 6x4, 8x3, 2x2
Day 5: Normal genetic 1xHB (boy), 1xEB (boy), 1xCM (girl)

Only 6 was good enough for PGD, and out of them only 3 came out normal. We transferred the Compact Morula girl, and got pregnant. As told I lost it 1 weak after BFP. We are soo devastated.

What could have been different? Before starting stimming, I didnt take any pretests exept from bloodtests, and two ultrascans when using menopur.

Could there be something wrong with me? Something I should test for?

The doctor told me that if this didnt work we could try self correction(?). Because the embryos could have been normal even do they came out abnormal. We have freezed dowm my dh sperm, so I can travel down alone first for ER, and then they take cells from the embryos on day 5, freeze them and I come back only if there is a normal girl. This seemes as a pretty good solution, but what are the chances here? I guess this is called aCGH? Do the embryos have do be at the blastocyst stage at day 5? I have heard that the girl are a bit slower growing?

I really hope to get some tips from you!

(The second paccage of Menopur was 6 month old. BB February 2013. I didnt notice before I had used it for 3-4 days). Do you think that this have cause the poor embryo quality?

Thank you

What type of technology was being used for the PGD? Looks like FISH which really doesn't tell you whether the embryo was really normal. Day 3 biopsy is particularly ill-suited for FISH and aCGH so day 5 biopsy is the way to go.

In my experience, high egg number with poor quality often = insulin resistance so I would get tested for this. I would ask them how the embryos were for other couples that went through at the same time. If they were slow too it could be a lab issue.

Also, I am not a big fan of the short protocol as a primary approach, as I have said many times. aCGH with GenderSure could be turned around so that you can have a day 6 transfer and no freezing.

[Mollo]

Thank you, Dr. Potter,

We did FISH 5 probe, day 3 biopsy and transfer at day 5.

I didnt use any supplements but folic acid. I also did eat about 90% carbs..

Now I eat low carb, take prenatal, coq10, folic acid, vitamin c, and fish oils.

We are cycling again soon. Start to stim in beg. of november. This time we will go for acgh, with 5 day biopsy and FET later on (hopefully in december). We have also changed the meds

We have frozen sperm from my husband. Do you know if it is more likely for girl-spermies to survive the freezing and thawing?

I have a good feeling, and sooo much hope!!

[Dr. Potter]

Thank you, Dr. Potter,

We did FISH 5 probe, day 3 biopsy and transfer at day 5.

I didnt use any supplements but folic acid. I also did eat about 90% carbs..

Now I eat low carb, take prenatal, coq10, folic acid, vitamin c, and fish oils.

We are cycling again soon. Start to stim in beg. of november. This time we will go for acgh, with 5 day biopsy and FET later on (hopefully in december). We have also changed the meds

We have frozen sperm from my husband. Do you know if it is more likely for girl-spermies to survive the freezing and thawing?

I have a good feeling, and sooo much hope!!

Why not fresh transfer?? Be sure to consider GenderSure/aCGH.

[Mollo]

I dont know if the clinic offer fresh transfer, but I will ask. Gendersure, I thought that was only available in the US? But we have chosen acgh