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Hi Carole, I have a question for you. I posted this in Ask the Dr section aswell, I am hoping to get an answer from an Embryologist prespective aswell.
My question is ...
I was looking in to day 5 biopsy with GSN. So in order to do day 5 biopsy the embys should be in blast stage right? So do you think if a cell is not removed on day 3 the embryo will have a high chances of going to the blast satge by day 5.
Thanks
Hi Mykids,
If the embryo is genetically healthy and the lab environment is good, I would have every expectation that the embryo would go on to blastocyst stage by day 5. These factors are most important for embryo development.
Day 3 biopsy can be tough for some embryos. Removing a cell on day 3 is suspected to be a contributing reason why some embryos may fail, either because they are traumatized by the biopsy or removal of one or two cells (out of eight on day 3) reduces the critical mass of the remaining embryo too much and slows the embryo's progress. In contrast, on day 5, biopsy of 2-10 cells (out of now 100+ cells in the blastocyst) appears to be better tolerated by the embryo. Will the embryo have a "high chance" of getting to day 5 without biopsy on day 3?- yes if the embryo is healthy and the lab is good. Being left alone on day 3 may be helpful too.
Hope this helps, Carole.
Thank you Carole for your quick reply, Do you know which center does day 5 biopsy & do a FET.
When we consult a RE what questions can we ask the RE to make sure there lab enviornement is good.
Do you recommend any fertility center for day 5 Biopsy. Are you aware of any good lab enviornement.
Thanks
You can determine if a clinic is good (good lab environment and good docs) by looking at their reported annual pregnancy rates. My blog has several posts on finding a good doctor and evaluating clinics you might like.
http://fertilitylabinsider.com/2010/...ctor-part-one/
http://fertilitylabinsider.com/2010/...ctor-part-two/
http://fertilitylabinsider.com/2010/...w-your-doctor/
You can find clinic-specific annual pregnancy data on various sites including the CDC website at http://www.cdc.gov/art/ARTReports.htm, or SART at http://www.sart.org/find_frm.html or there is also a private site which ranks clinics based on SART outcomes http://fertilitysuccessrates.com/index.html. The SART data is a subset of the CDC data because all clinics have to report to CDC by federal law, however there is no federal requirement to be a SART member and use their services to report. That means that some very good clinics may not show up in the SART database but they will be in the CDC database.
I don't recommend specific clinics but you should be able to find good clinics in your area, then call to verify if they offer PGD and day 5 biopsy. You might ask them about how long they have been offering these services and about their pregnancy rates for PGD cases relative to non-PGD cases. There PGD pregnancy rates should be similar to their non-PGD rates- both should be good- around 50% or better for the youngest age group. Hope this helps, Carole.
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Thank you carole!