WWYD? Day 3 biopsy w/fresh transfer or Day 5 w/frozen

Hey all, longtime IG member here just finding my way over to this site. Some of you may remember me as ahimsa_malozzi. I've been ttc a DD for waaaaayyyyy too long! Joined IG back in 2006 when my DS1 was just one and I was trying to sway the odds for my second child to be a girl. Swaying failed, and after DS2 was born I tried MS/IUI twice at GIVF in 2009 but never got pg, so then I did a really thorough super good sway but nope - DS3 born last November! So now I'm planning on doing PGD/IVF late this year.

Had my consultation last week and I'm happy with the clinic and doctor I chose - best in the area for PGD without a doubt. Part of why I was so excited about them is that they're the only ones around here doing day 5 blastocyst biopsies with aCGH and day 6 fresh transfers. But then I found out at the consultation that the aCGH they do with that procedure is only 96% for gender. After all this time, I'm not about to settle for anything less than 99.9%!

I talked to them, and my options are to either do a day 3 biopsy with FISH (guess I'd do five probe) for a fresh transfer, or I could do GSN with parental assist with a day 5 biopsy, but it would have to be a frozen transfer. They claim a 90% thaw survival rate. I guess I could also do GSN with a day 3 biopsy and fresh transfer, but I didn't really talk to them about that. The embryologists I spoke to at the clinic both recommend the day 5 blast biopsy with FET because they say blast biopsy is so much better that it outweighs the drawbacks of FET.

What do you guys think I should do?

With 24 chromosome testing, I would never do a day 3 biopsy. I am bot comfortable with saying that one cell of an eight cell organism defines that whole being. Day 5 all the way with GSN or aCGH- quite a few on here have and are doing aCGH and gender doesn't seem to be an issue- did they state why? Either they see two XX or not. Seems simple enough to me.

FETs are nothing to fear at all. Any good embryo will make the thaw and doing it that way, only blasts will be frozen so all should make the thaw.

The other issue with day 5 biopsy, 6 transfer is that your embryos MUST be blasts on day 5 in order to do the biopsy. If they have to wait until day 6, you're looking at a FET anyway!

Hi! I remember you from IG. I'm ABC123 from IG and you can see what I've been up to in my siggie (lol as it's ridiculous!!!!).

I think if we cycle again, I'm going to do the day 5 biopsy w/ 24 chromosome and freeze to do a FET the next month. I've failed at my fresh cycles four times already so I see no benefit in trying a day 3 biopsy w/ fresh transfer again. Supposedly the "up and coming" way to do it is day 5 or day 6 blastocyst biopsy and then freeze to do a FET and hopefully your body is ready for FET. Last summer I consulted w/ a clinic who was doing just that and I shyed away from them b/c I didn't want a FET out of fear of losing them to the thawing process. That was after my second failed fresh. I wish I did but I didn't so here we are.

Lots of luck to you!!!!!

Thanks for the input, guys! You're making me feel better about going straight to FET. I feel nervous about all the drugs circulating still in a fresh cycle, but then I looked up the protocol for FET and you've still got to take Lupron shots and stuff, right? I guess that's less intense though, and most of the stuff is stuff you'd be taking for a fresh transfer anyway, just taking it later.

So what happens after the retrieval cycle with FETs? You get AF, then do you go on BCPs or what? Another annoying thing is I just found out my clinic closes for Xmas for four weeks starting in mid-December. We're hoping to cycle in November (can't start any earlier than around Halloween because we're going on vacation with the in-laws in mid-October and that's already booked), so that means I guess I'd either have to have two post-ER cycle AFs and then do my ET cycle in like early February, or I'll have to just wait and start it all in the New Year, which I'd really rather not do since it's already going to be a double cycle at least and I just don't want to wait that long. So I'm trying to create a new mental calendar for this, but I don't know what to expect now.

Also, how likely is it that I'll get blasts to freeze? Is it pretty uncommon to not have any embryos go to blast by day 5 or 6?

Thanks again ladies, I look forward to being a part of this new community!

pinksapphire (ABC123), I really like your new name! I'm so sorry about all you've been through, I can't even imagine. You're from the NYC area, right? Who are you thinking about cycling with? Have you worked with Dr. Braverman? Everybody says such nice things about him. I actually contacted him a few months ago online and he called me like ten minutes later! I'm like a five hour drive from Long Island, though, so I'm going local for now. Do you think you'll try again soon? Anyway, nice to see you again, and hope things start getting better for you soon!

Hi Cultured Pearl! I like your new name too! :)

My last two cycles and my natural, surprise pregnancy was all with Dr. Braverman. He's local to me so it's easy. He & his staff knows me so well at this point that I'm going to stay with him again. My first was with SIRM and my second was with NYU. I got cut during my retrieval at NYU and had serious internal bleeding from it that landed me in the hosptial for TWO days! Needless to say I won't be going back there even with their "good reputation" (and I had my worst amount of eggs from them as well).

I actually have no idea about the particulars w/ frozen cycles just think at this point it's something I should try. Do you like your local clinic? I'm not sure when we'll try again as I haven't gotten AF yet after the D&C from the miscarriage.

And you are right in that Dr. B. is very nice! He looked genuinely, truly upset when he did the sono and saw that my 9w2d old baby's heart stopped beating.

My clinic likes for you to get the AF from the fresh cycle, wait for the next natural AF and then do the FET that next cycle. They had me use OPK's and then I started Lupron 7 days after a + OPK. You stay on Lupron until transfer and estrace and PIO are added in along the way before transfer. Those 2 I continued for 12 weeks. The FET is so easy and all frozen blasts should thaw just fine.

Uch, pinksapphire, I remember the bleeding after ER story, but I forgot that was you! That sucks! I'm glad you're with Dr. B now and you feel good with him. It's so hard to do stuff like this when you don't have nice doctors and nurses.

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Originally Posted by nuthinbutpink

My clinic likes for you to get the AF from the fresh cycle, wait for the next natural AF and then do the FET that next cycle.

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Okay that makes sense. I'm going to have to wait for the next AF anyway because of the clinic being closed for four weeks for the holidays. Question - do they ever give you BCP for that in between cycle (like put you on them a few days after the post-ER AF starts) so the timing is better? Because can't that next natural AF take a jillion years to show up otherwise?

bump

CP- just wanted to say welcome! :) As you know I will also be doing aCGH/GSN with parental assist, but I will be doing day 3 biopsy with day 5 fresh transfer (hopefully, assuming we have a normal female to transfer). My trigger is tonight and ER Saturday so we'll know next week if that is the case. But I wanted to tell you if you are interested in talking to someone more about Day 5 biopsy with FET, "lindi" (she is in the HT private forum) just did this and got a BFP! I'm sure she would be more than happy to give you information about it. Best wishes!! :luck: :luck: :luck:

Oh my gosh, Erinhen, how exciting! Good luck, I hope you get a perfect sticky pink embie to transfer, can't wait to hear your results! Thanks for telling me about lindi, too, that's great news for her. I'm going to become an official member on here eventually, I've just been busy with preschool graduations and birthdays and what have you and haven't gotten around to it yet. Pretty soon though!

I have nothing to add but a huge WELCOME!!

How much more cost is added to a FET cycle? What meds are needed and how many u/s?

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Originally Posted by Bugsbunny

How much more cost is added to a FET cycle? What meds are needed and how many u/s?

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If you do a medicated FET, you use lupron beforehand to suppress ovulation, typically, and then add in estrace and PIO to build your lining and support the pregnancy. I had a baseline check to make sure I was suppressed and then 2 more checks for lining and then the FET. It is very easy and you can pick the date for the FET IF your RE will let you!

My clinic was $3500 for a FET plus meds.

Oh yikes!!! My RE thought I might do better with a FET because I over stimulate. But then that would cost me an additional $3500 in addition to the $10,000 +/- for the ivf cycle itself?? Have you heard of that some women do better (have better results with a pregnancy) by doing a FET if they tend to hyper stim while cycling?

If you tend to hyperstim, then many would recommend frozen.

But I did want to suggest you discuss one other option with your RE... day 5 biopsy with fresh day 6 transfer. You can do that if you are close to Reprogenetics... 24 aCGH, 5 probe FISH or fewer probes.

Good luck!

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Originally Posted by erinhen

CP- just wanted to say welcome! :) As you know I will also be doing aCGH/GSN with parental assist, but I will be doing day 3 biopsy with day 5 fresh transfer (hopefully, assuming we have a normal female to transfer). My trigger is tonight and ER Saturday so we'll know next week if that is the case. But I wanted to tell you if you are interested in talking to someone more about Day 5 biopsy with FET, "lindi" (she is in the HT private forum) just did this and got a BFP! I'm sure she would be more than happy to give you information about it. Best wishes!! :luck: :luck: :luck:

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Do you know how old "lindi" is when she did her cycle and where she cycled? Is she on the public forum as I would love to talk with her...how do I contact her? Thanks :)