Biopsy on day 5

[bows&ribbons]

Based on your experience, do you think there could be any potential harm to the baby bc of a day 5 biopsy indirectly -- bc of harm to the placenta or to other maternal membranes thereby affected? Would you be more concerned about a biopsy on day 3 since it is of the embryo? Do you think day 5 biopsies are the future of pgd?
Thanks!!

[Carole]

Dear bows&ribbons,

Good questions. To answer your last question first, yes, I think day 5 biopsies are the future of PGD. Any biopsy intervention with the embryo on any day could outright kill the embryo-if poorly done- but I am not aware of any harm from biopsy that damages the placenta only. Biopsy of the trophectoderm has several advantages. First, more cells can be sampled for testing, making the test more reliable. Second, the trophectoderm cells do not provide cells to the actual future baby, just the placental membranes. On day 3, you are taking cells that are part of the critical mass of cells that give rise to both placental and fetal lineages and there is a limit to how many cells you can take without affecting the embryos ability to keep going. Finally, there is some evidence that waiting for another month to transfer the embryos (because day 5 biopsy requires freezing the post-biopsy embryo to allow time for the genetic test results) may result in better implantation. Why?- because the uterus can be optimized for implantation, without the need for large hormonal doses needed for egg stimulation in a fresh cycle which are not necessarily the best for the uterine lining. Having said that, in order to get the best outcomes from trophectoderm biopsy, the lab has to be very good at not only biopsy techniques but also freezing embryos. But overall, I think that the best labs will be doing day 5 biopsy only in the future. Best Wishes, Carole

[bows&ribbons]

thank you so much for your response. Is there any risk that the potential placenta and membranes could be damaged in a way that the embryo won't receive proper or adequate nutrients bc of the biopsy?
Thanks!!!!

[Carole]

I have never read or heard that biopsy damage created problems for the placental membranes and nutrient exchange. Remember at trophectoderm biopsy, you are removing 2-10 cells from an embryo containing between 50-150 cells. The placenta stage at which nutrient exchange is an issue is further down the road- when the placenta has become a tissue of millions of cells. If you damage an embryo during biopsy, you are most likely to kill it, rather than cause specialized tissue damage. Best Wishes, Carole.