Day3 FISH v Day5 aCGH?

[coralsky]

Hi Carole

I am hoping you can help with something I am wondering about regarding these 2 types of PGD testing methods...

I know that Day5 aCGH is better in that it will test all chromosomes, but my question is- if you KNOW you are not going to get a high number of eggs/normal embryos, is there ANY advantage at all to using Day3 FISH over Day5 aCGH?

I have previously had 3 failed cycles at a European clinic, and I am considering the possibility of one last cycle in the US next year...but I only have one ovary, and never get a high number of eggs to begin with (10, 7, 11) so I am really afraid of a No Transfer...

I was therefore wondering if it is possible that a *potentially* normal embryo may not survive in the lab until day6 (in order to get a fresh transfer from day5 aCGH) but may have a chance of making a baby if transferred earlier?

I realise that most of the time embryos not surviving to day6 in the lab will be a lot less likely to make a baby, but I wondered if it is possible that it happens occasionally where one might...I am hoping you may be able to shed some light on this, as it may help me a decision re the testing methods.

Many thanks in advance

[Carole]

Hi CoralSky,
I would still prefer day 5 testing with aCGH. It is a more robust test than FSH and more cells are tested on day 5 than day 3.

It is always possible that the embryos stop to grow and don't make it to day 5. Healthy embryos should continue to grow unless there is something wrong will the culture system. By the same token, genetically ABnormal embryos will also continue to grow at least to day 5 so genetic analysis is still very important to avoid transferring these abnormal embryos. Growth in culture is a poor indicator of genetic problems compared to PGD.

A "no transfer" because the embryo is abnormal is disappointing but look at it this way; if you transfer without the information, you may still experience a disappointing loss a little further down the road. Good Luck with whatever you decide!!
Carole

Hi Carole

I am hoping you can help with something I am wondering about regarding these 2 types of PGD testing methods...

I know that Day5 aCGH is better in that it will test all chromosomes, but my question is- if you KNOW you are not going to get a high number of eggs/normal embryos, is there ANY advantage at all to using Day3 FISH over Day5 aCGH?

I have previously had 3 failed cycles at a European clinic, and I am considering the possibility of one last cycle in the US next year...but I only have one ovary, and never get a high number of eggs to begin with (10, 7, 11) so I am really afraid of a No Transfer...

I was therefore wondering if it is possible that a *potentially* normal embryo may not survive in the lab until day6 (in order to get a fresh transfer from day5 aCGH) but may have a chance of making a baby if transferred earlier?

I realise that most of the time embryos not surviving to day6 in the lab will be a lot less likely to make a baby, but I wondered if it is possible that it happens occasionally where one might...I am hoping you may be able to shed some light on this, as it may help me a decision re the testing methods.

Many thanks in advance

[coralsky]

Hi CoralSky,
I would still prefer day 5 testing with aCGH. It is a more robust test than FSH and more cells are tested on day 5 than day 3.

It is always possible that the embryos stop to grow and don't make it to day 5. Healthy embryos should continue to grow unless there is something wrong will the culture system. By the same token, genetically ABnormal embryos will also continue to grow at least to day 5 so genetic analysis is still very important to avoid transferring these abnormal embryos. Growth in culture is a poor indicator of genetic problems compared to PGD.

A "no transfer" because the embryo is abnormal is disappointing but look at it this way; if you transfer without the information, you may still experience a disappointing loss a little further down the road. Good Luck with whatever you decide!!
Carole

Hi Carole

Thank you SO much for replying so quickly, I really appreciate it!

Yeah, that does make sense...so as long as I choose a good clinic, with a good lab & embryo culture system, then all normal embryos should make it to day6 anyway?
That answers my question completely and puts my mind at rest...

And I totally agree that while a NT is obviously not the outcome I would want, it is better than an early miscarriage which would be heartbreaking. I just wanted to check I wasn't missing something on comparing the 2 testing methods.

I will def. use aCGH if I decide to cycle again then.

Again, thank you soooo much