What should I ask during a consultation?

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May 11th, 2013, 06:38 PM
Alyssasmom789

What should I ask during a consultation?

I'm new to this ht world and not even sure if we will be taking this route just yet. During a consultation with ivf doctors what should one ask (besides cost)? What are major things to look for? Ask?
May 17th, 2013, 12:28 AM
Dr. Potter

Quote:

Originally Posted by Alyssasmom789

I'm new to this ht world and not even sure if we will be taking this route just yet. During a consultation with ivf doctors what should one ask (besides cost)? What are major things to look for? Ask?

I would ask how many PGD cases they do and how they see PGD affecting the results from IVF. They should do a lot and should feel that there is a large increase in pregnancy rates derived from selecting the best embryos that are genetically normal for transfer. You should ask them what type of technology they are using. If they are using FISH or PCR only or aCGH on day 3, find another clinic as these techniques do not offer any embryo selection advantage. Ask them how they are evaluating your ovarian reserve. This is how they will determine your protocol and how you will be able to assess your prognosis before you commit to doing IVF. I would be concerned if they do not asses ovarian reserve (I see a lot of patients where this is the case if you can believe it!) or rely on only a single testing (like Day 3 FSH/E2). We use three tests (Day FSH/E2, AMH and antral follicle count. The truth about ovarian reserve helps create better protocols and more informed patients. Finally, ask them how they are assessing your uterine cavity. Amazingly, many European centers do not bother checking for intrauterine pathology that can prevent success. I hope that this helps.
May 17th, 2013, 01:17 AM
Alyssasmom789

Wow thank you sooooooo much!
May 23rd, 2013, 07:21 PM
Alyssasmom789

Quote:

Originally Posted by Dr. Potter

I would ask how many PGD cases they do and how they see PGD affecting the results from IVF. They should do a lot and should feel that there is a large increase in pregnancy rates derived from selecting the best embryos that are genetically normal for transfer. You should ask them what type of technology they are using. If they are using FISH or PCR only or aCGH on day 3, find another clinic as these techniques do not offer any embryo selection advantage. Ask them how they are evaluating your ovarian reserve. This is how they will determine your protocol and how you will be able to assess your prognosis before you commit to doing IVF. I would be concerned if they do not asses ovarian reserve (I see a lot of patients where this is the case if you can believe it!) or rely on only a single testing (like Day 3 FSH/E2). We use three tests (Day FSH/E2, AMH and antral follicle count. The truth about ovarian reserve helps create better protocols and more informed patients. Finally, ask them how they are assessing your uterine cavity. Amazingly, many European centers do not bother checking for intrauterine pathology that can prevent success. I hope that this helps.

DR. POTTER I EMAILED A PLACE IN CHICAGO AND THIS WAS OUR CONVERSATION. WHAT DO YOU THINK?

THIS IS THE EMAIL I RECEIVED FROM A PLACE IN CHICAGO, IL CALLED RGI (REPRODUCTIVE GENETIC INSTITUTE).

Thank you for your inquiry to RGI about our PGD services. I have attached some information about PGD for aneuploidy (chromosome abnormalities) and gender information.
Are you currently working with an IVF center? We have an affiliated physician, Dr. Ilan Tur Kaspa who can be reached at 773-472-4949 or at info@infertilityihr.com. PGD is done in conjunction with an IVF center and once we know which physician you are working with, I will know which testing strategies are available to you. Once I know that, we can set up a time for a phone consult. Thanks!

I said this back to her! I do not have a physician. I am doing a lot of researching and talking to a number of places regarding pgd ivf to have a boy. We were going to travel internationally but its too hard so we have decided to do it locally.

She replies: Gender selection can be included with any of our aneuploidy testing (X and Y are on both the FISH panels and aCGH/24 chromosome testing). Our accuracy is 90-95% for FISH testing and 95-98% for the aCGH testing. I attached a price list to my first email – the FISH testing is either 1700 or 2700 and the arrayCGH is 3000 for up to 8 samples. If you work with a center where we have to do the biopsy and travel, there is a $1,500 biopsy fee and potentially a travel fee of up to $2,000. Many patients do aneuploidy testing in general, some for chromosome screening only and others for gender selection. We don’t separate our aneuploidy patients by categories – we also have several people who add on aneuploidy screening to other testing for gender selection or general screening so it is hard to differentiate. And as I mentioned, our accuracies are 90-95% for FISH testing and 95-98% for aCGH. The pregnancy success rates will come from the IVF center. Our laboratory does the PGD testing and works with you and the physician during your IVF cycle. IVF physicians will send cells to us from the embryos they have created through the IVF cycle. If you look through the information packet I attached in my first email, they should help to explain the process. We will go through all of this during a phone consult but until you have an IVF physician, it doesn’t make a lot of sense to have a PGD consult since I want to make sure I’m giving you the right information.
May 31st, 2013, 03:32 AM
Dr. Potter

Quote:

Originally Posted by Alyssasmom789

DR. POTTER I EMAILED A PLACE IN CHICAGO AND THIS WAS OUR CONVERSATION. WHAT DO YOU THINK?

THIS IS THE EMAIL I RECEIVED FROM A PLACE IN CHICAGO, IL CALLED RGI (REPRODUCTIVE GENETIC INSTITUTE).

Thank you for your inquiry to RGI about our PGD services. I have attached some information about PGD for aneuploidy (chromosome abnormalities) and gender information.
Are you currently working with an IVF center? We have an affiliated physician, Dr. Ilan Tur Kaspa who can be reached at 773-472-4949 or at info@infertilityihr.com. PGD is done in conjunction with an IVF center and once we know which physician you are working with, I will know which testing strategies are available to you. Once I know that, we can set up a time for a phone consult. Thanks!

I said this back to her! I do not have a physician. I am doing a lot of researching and talking to a number of places regarding pgd ivf to have a boy. We were going to travel internationally but its too hard so we have decided to do it locally.

She replies: Gender selection can be included with any of our aneuploidy testing (X and Y are on both the FISH panels and aCGH/24 chromosome testing). Our accuracy is 90-95% for FISH testing and 95-98% for the aCGH testing. I attached a price list to my first email – the FISH testing is either 1700 or 2700 and the arrayCGH is 3000 for up to 8 samples. If you work with a center where we have to do the biopsy and travel, there is a $1,500 biopsy fee and potentially a travel fee of up to $2,000. Many patients do aneuploidy testing in general, some for chromosome screening only and others for gender selection. We don’t separate our aneuploidy patients by categories – we also have several people who add on aneuploidy screening to other testing for gender selection or general screening so it is hard to differentiate. And as I mentioned, our accuracies are 90-95% for FISH testing and 95-98% for aCGH. The pregnancy success rates will come from the IVF center. Our laboratory does the PGD testing and works with you and the physician during your IVF cycle. IVF physicians will send cells to us from the embryos they have created through the IVF cycle. If you look through the information packet I attached in my first email, they should help to explain the process. We will go through all of this during a phone consult but until you have an IVF physician, it doesn’t make a lot of sense to have a PGD consult since I want to make sure I’m giving you the right information.

They are a large and reputable PGD center. They are known for being experts regarding PGD for single gene disorders and genetic disease prevention. FISH is a bad idea. They are being realistic and taking into account the wide variation in expertise at the many clinics that they are affiliated with and the fact that many of them are not capable of doing trophectoderm biopsies and so must resort to day 3 biopsy with aCGH. Avoid aCGH with day 3 biopsy. The 95-98% gender accuracy that they quote using aCGH is why we are coming out with GenderSure. 100% is better.
May 31st, 2013, 12:34 PM
Alyssasmom789

Quote:

Originally Posted by Dr. Potter

They are a large and reputable PGD center. They are known for being experts regarding PGD for single gene disorders and genetic disease prevention. FISH is a bad idea. They are being realistic and taking into account the wide variation in expertise at the many clinics that they are affiliated with and the fact that many of them are not capable of doing trophectoderm biopsies and so must resort to day 3 biopsy with aCGH. Avoid aCGH with day 3 biopsy. The 95-98% gender accuracy that they quote using aCGH is why we are coming out with GenderSure. 100% is better.

so what kind of testing in my looking for when I try to find a clinic