Is there any explanations to abnormal embryos?

Dear Carole Wegner

Earlier this month I did my first IVF/PDG-cycle in Europe and all my five tested embryos came back with abnormal genetic analysis after PGS array-CGH-testing. Is there any explanations to why this happened?

I am 40, no history of infertility, 3 healthy sons. Had good pretesting. AMH: 11.9, FSH: 6.9, LH: 7.8. 13 eggs retrieved. 8 fertilized. 5 was biopsied on day 5/6 and frozen.

My hubby has low morphology (1 pct.) but very high numbers on all other semen-values. We used frozen s. I took all the recommended vitamins and dietary supplements including DHEA and melatonin. My protocol was 225 Gonal-f for 12 days, Orgalutran and Ovitrelle as trigger.

The abnormal embryos were all grade 2 HB and FHB, but had following problems:

- one (XX) had gain of chromosomes 9, 21 and susp. partial gain of chromosome 11q.
- another one (XY) had susp. partial gain of chromosome 16p in mosaic.
- another one (XX) had gain of chromosomes 20 and susp. loss of chromosome 8 end 9 in mosaic.
- another one (XX) had multiple chromosomal abnormalities.
- the last one (XY) had susp. partial loss of chromosome 17p.

Am I unable to produce healthy embryos because of my advanced maternal age? Is it just bad luck? Could it be a lab-issue and that the embyo could be re-biopsied and turn out to be normal? Or could it be other factors such as emotionel stress during stim-period (a close relative of mine was about to die during this proces)?

I know you have answered this kind of question several times before, but I would really accpreciate if you have time to write some words.

Thank you so much in advance.

Quote:

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Originally Posted by Dreamsister

Dear Carole Wegner

Earlier this month I did my first IVF/PDG-cycle in Europe and all my five tested embryos came back with abnormal genetic analysis after PGS array-CGH-testing. Is there any explanations to why this happened?

I am 40, no history of infertility, 3 healthy sons. Had good pretesting. AMH: 11.9, FSH: 6.9, LH: 7.8. 13 eggs retrieved. 8 fertilized. 5 was biopsied on day 5/6 and frozen.

My hubby has low morphology (1 pct.) but very high numbers on all other semen-values. We used frozen s. I took all the recommended vitamins and dietary supplements including DHEA and melatonin. My protocol was 225 Gonal-f for 12 days, Orgalutran and Ovitrelle as trigger.

The abnormal embryos were all grade 2 HB and FHB, but had following problems:

- one (XX) had gain of chromosomes 9, 21 and susp. partial gain of chromosome 11q.
- another one (XY) had susp. partial gain of chromosome 16p in mosaic.
- another one (XX) had gain of chromosomes 20 and susp. loss of chromosome 8 end 9 in mosaic.
- another one (XX) had multiple chromosomal abnormalities.
- the last one (XY) had susp. partial loss of chromosome 17p.

Am I unable to produce healthy embryos because of my advanced maternal age? Is it just bad luck? Could it be a lab-issue and that the embyo could be re-biopsied and turn out to be normal? Or could it be other factors such as emotionel stress during stim-period (a close relative of mine was about to die during this proces)?

I know you have answered this kind of question several times before, but I would really accpreciate if you have time to write some words.

Thank you so much in advance.

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Dear Dream Sister,
Unfortunately, the most likely explanation is your maternal age, as you suggest. Because the addition or loss of chromosomes (called aneuploidy) is something that happens to all of us as we age and exactly what happened with your eggs. You can be super health-conscious and it won't reverse the effect of time. I would guess that your three healthy boys were born a few years ago. Honestly, unless you are very rich-both financially and with deep emotional reserves to overcome repeated dissappointment, I wouldn't spend more on this approach using your own eggs. It may be that you'd need 20 eggs retrieved to find one healthy one --or a 100. It might make more sense to adopt a baby girl or use donor eggs if you want to take a chance on IVF again. None of the other things you mentioned are likely to be the cause of this outcome. I wish you much good luck going forward with whatever path you choose to add a girl to your family! Best wishes, Carole

Dear Carole. Thanks a lot for your honest answer. Yes, my healthy sons were conceived when I was 31, 32 and 35 years old. I am not rich and your answer have helped me come to piece with my decision about not doing IVF again. My urge for a DD is not that big that I want to adopt or use DE. If we choose to have a fourth child (no matter the gender) I think the best way is to do it naturally and let my body do the job in picking out a healthy embryo. If I am still fertile I think this will be easier (and maybe also faster) than IVF.