First IVF/PGD failed--no normal embryos to transfer

[anythingforpink]

Hi there,

I am new to the boards and just completed my first IVF cycle, which failed. We are devastated and I am hoping that some of you ladies may have some insight or at least have heard of this happening.

I have 2 boys, ages 4 and 2 and have desperately wanted a little girl forever. My DH and I embarked on the IVF/PGD journey several months back to ensure that our third child would be a girl, since neither one of us would like to have more than 3 children. I am 34, DH is 37. Neither one us has any known fertility issues. We got pregnant with my oldest son on the first try, and with my second son on the second try. All of the tests we took before starting medication came back as "normal"...

I started stims on Aug 16th (gonal-f and menopur, and then eventually ganirelix). I responded well and had 16 eggs retrieved during ER. 14 of the 16 were mature and all 14 were successfully fertilized with ICSI. All 14 were biopsied on day 3 for aCGH. All embryos survived the biopsy on day 5, the morning of the transfer.

While I am on the table, naked from the waist down, having an U/S tech check my bladder every 5 minutes, the doctor comes in with the report from Reprogenetics, saying that he has the report and the news "may not be what I want to hear."

He scans through the report VERY quickly, and basically tells me that out of 14 embryos, only 3 were girls. Of the 14 embryos, only 3 were normal. None of the 3 normal embryos were girls. So we had nothing to transfer. I was shocked. Partly at how nearly 80% were boys, but more so that nearly 80% were abnormal. I burst in tears, and the doctor excused himself.

A few minutes later, he returned and my husband asked him a lot of questions related to the accuracy of the tests. The doctor assured him it was "very accurate--as accurate as it gets". DH asked him how it was possible that we would have SO many abnormal embryos. The doctor blamed it on my age even though I am under 35. I asked what would happen if we transferred one of the girl embryos. The doctor said no pregnancy or a miscarriage. We felt as thought we exhausted everything and we left.

Later, I researched a bit and found that in many cases, day 3 was not necessarily the most reliable method of testing and normal embryos can sometimes be identified as abnormal on day 3 when they are not, partly due to the small amount of DNA analyzed..I feel sick thinking we discarded so many embryos that COULD have been normal. I am upset that the option to re-biopsy on day 5 was not offered to us.. We are considering doing another cycle, this time with a day 5 biopsy, but wonder if we would get the same results. I have so many questions, and figured I would ask here to see if anyone had any advice or past experiences that might help to clear this up!

Thanks in advance!

[nuthinbutpink]

I'm so sorry about your NT. 3/14 normal is pretty typical for your age. Had they been the right gender, that's an awesome cycle. So, gender can really make a good cycle look bad.

Now, day 3 aCGH is NOT what you want to use when you are doing this for gender. It isn't always accurate. You need to use day 5 testing for gender accuracy.

What clinic did you cycle with? There is a HT guide in the member section and all of the HT talk is in the private/member forums. It's worth the $12.

[HopeandDreamG]

3 normals is great at your age as has already been pointed out. Gender makes this much harder.
Welcome by the way!

[anythingforpink]

Thank you for the feedback. It does help to know that these results are not atypical, but I guess I just wish I was more prepared for them. When we had our initial consult (at FCNE) we were told that for our first cycle--given our age and previous history--gave us a 70-80% success rate. I guess we assumed he meant that this would work the first time..but that's probably not what he meant! I think that is why we were so stunned to have 80% abnormal embryos. Oh well, we will just try again, and this time be more realistic about the results we receive.

Nuthinbutpink--I noticed you said you should not do 3 day for GS because the accuracy is not great. Is Day 3 considered inaccurate only for determining the sex and considered accurate for the other chromosomes it tests for? I saw a post from yesterday (I think it may have been a post of yours?) where Dr. Sher referred to 3 day aCGH as "fraught with issues"...after reading that, I am concerned with the accuracy of all the results, gender and otherwise!! Just wanted to get your take on this as it seems as though you have a lot of information. Thanks for the advice too on becoming a member. I will do that and check out the other info posted to the forums!

Thanks again

[nuthinbutpink]

We have had people use day 3 CGH for GS and end up pregnant with an opposite. They were trying for a girl and gave birth to boys. Dr Sher who's clinic developed CGH has advised that it should not be used for gender. I would not use it again.

We have had people cycle with FCNE and they are not using day 3 CGH. So, there may be another option there. Most big clinic are doing day 5 testing. It's more accurate all around.

The Y chromosome is so small, it's not seen on day 3 sometimes and the computer assumes its a female. That's the day 3 problem.

[Orchidia]

In my consult with FCNE, they said they do Day 5 aCGH, not Day 3. Had they said Day 3, I would've run. I don't understand why they did Day 3 for you... Anyway, is day 5 aCGH good or is another type of gender testing better??

[Orchidia]

Oh also, for my age, which is older (38), they told me 60% of my eggs would be bad... Does that translate into more than 80% abnormal embryos??

[anythingforpink]

This is really interesting...I had been doing research on the 3 day vs 5 day aCGH and had read that 5 day was safer for the embryo and also read some positive things regarding FET. I called the office about a week prior to starting stims saying I wanted to do the 5 day and the PGD coordinator AND the doctor got on the phone with me simultaneously and encouraged me to do the 3 day. After talking to the doctor, I felt reassured that the results would be fine, so we moved forward with the 3 day. I am regretting so much right now!!

Not sure what having 60% bad eggs translates to for abnormal embryos. I was given no indication that I would have bad eggs or embryos. If anything, after our consultation, DH and I left the office thinking this would be a slam dunk and we would get our girl on the first attempt. Not so much.

Are you going to be cycling in Reading?

[nuthinbutpink]

The chart pictured below helps to determine, on average, the percentage of normal embryos (percentage, bold) retrieved for patients given their maternal age and the total number of embryos retrieved.The chart is also helpful for estimating the average pregnancy rate for patients in each age group (percentage, italicized). Green groups are patients with the highest likelihood for success whereas red groups are patient groups with the lowest likelihood for success. This is for day 5 aCGH.

[nuthinbutpink]

Oh also, for my age, which is older (38), they told me 60% of my eggs would be bad... Does that translate into more than 80% abnormal embryos??

The majority of the overall embryos created on day 1 will be abnormal. The embryos that make it to day 5 have a good chance of being normal though. You will lose a good number from fertilization to day 5 though due to natural attrition.