First IVF with PGD soon. Anyone else?

[Sophie2015]

After 5 consecutive mc's my RE feels we have an egg quality issue. He thinks IVF with PGD is the best option for us. I conceive fairly easily only to mc. We know my 15 week loss was due to T21 and genetics is currently pending on my most recent loss. We have no data on the other three.
Anyone else starting or been through IVF with PGD? I'm almost 44. I respond well to the drugs. My 2 Follistim/IUI cycles I over responded both times with 7 mature follicles despite decreasing my Follistim dose each cycle. My concern is my old eggs won't survive the overall process, the length of time the whole process takes to find out if any of my embryos are normal, etc.
Anyone have any insight, words of wisdom, encouragement, or maybe even a voice of reason to say 'don't even try it'?
Thanks for any input. Really struggling right now.

 

[3chords]

Hi!

I am assuming you mean PGS not PGD? PGD eliminates embryos with a specific genetic mutation whereas PGS looks for euploidy.

I have done IVF with PGS twice. The first time resulted in our son who is 10 months. We just did another round (did not have any frozen embryos left) and got 2 PGS normals which are sitting in the freezer awaiting transfer in October. Like you, I had recurrent pregnancy loss (twice) before we went down the PGS route and I also have an egg quality issue though I am younger (36 now).

I wish you the best of luck!

 

[Sophie2015]

They call it PGD where I am but yes it is looking for euploidy.

How long did each cycle take for you? I know these things can't be rushed but I don't want 1 PGD cycle to take up my entire 44th year.

 

[BronteForever]

Sophie - I'm following just so I can see how it goes for you. We were originally slated to do PGS on our embryos, but as you know we didn't have any make it to blastocyst stage so they could be biopsied.

The time frame will depend on your clinic and your protocol. I did a short protocol, so started stims on CD3 and retrieval was 12 days later. Most of the clinics send off the biopsied tissue to a genetics lab out of state, so you normally have to have the embryos frozen and get results about a week later. There are some clinics that do genetic testing within their IVF lab and can get test results before a transfer, but the vast majority you will need to do a FET.

Our clinic requires two bleeds in between a fresh and frozen cycle. But that varies by clinic, some will let you do it the next cycle. But considering most people start their periods within one week of a fresh cycle, it's probably better to wait until your body has recovered a bit from the meds.

So total you are looking at around 3 months, depending on when they can get you in and again what the protocol they put you on is.

So excited for you to start. Since you have had such luck getting pregnant before, I really do think you might have luck with IVF and genetic testing.

 

[3chords]

How long it takes depends on your protocol.

My clinic sends the biopsied cells to Genesis Genetics in Michigan, the results are guaranteed within 24 hours. So you can proceed in a fresh cycle. I have never done it that way because the first time I had developed OHSS and the second time we just wanted to do the same as the first time plus we wanted to wait a bit to hopefully space the 2 kids a bit more.

I have gone straight to FET after the fresh cycle. I didn't feel like I really had to recover from the fresh cycle but my clinic also does a very long FET with Lupron Depot, so you have about 8 weeks between starting your post-IVF bleed and the transfer.

In our first transfer, we transferred 2 PGS normal embryos (both male) but only one took. So PGS isn't a guarantee of success, though the odds are way higher than with anything else.

 

[BronteForever]

Really, 3chords? That is super interesting. My clinic uses Genesis as well but we wouldn't have gotten results for a week. I wonder if they have partner clinics that they have a quicker turn around time for.

So would they biopsy on day 5 and then transfer on day 6? Or does your clinic biopsy the embryos before blast stage? Just curious because I want to look into it more for my next cycle should I get there, didn't even have any make it that could be biopsied.

 

[Sophie2015]

Sophie - I'm following just so I can see how it goes for you. We were originally slated to do PGS on our embryos, but as you know we didn't have any make it to blastocyst stage so they could be biopsied.

The time frame will depend on your clinic and your protocol. I did a short protocol, so started stims on CD3 and retrieval was 12 days later. Most of the clinics send off the biopsied tissue to a genetics lab out of state, so you normally have to have the embryos frozen and get results about a week later. There are some clinics that do genetic testing within their IVF lab and can get test results before a transfer, but the vast majority you will need to do a FET.

Our clinic requires two bleeds in between a fresh and frozen cycle. But that varies by clinic, some will let you do it the next cycle. But considering most people start their periods within one week of a fresh cycle, it's probably better to wait until your body has recovered a bit from the meds.

So total you are looking at around 3 months, depending on when they can get you in and again what the protocol they put you on is.

So excited for you to start. Since you have had such luck getting pregnant before, I really do think you might have luck with IVF and genetic testing.

I have a very vague memory of being told 3 months total time and that the embryos would be frozen. This was at my initial consult with my RE in April of 2015. So what you are saying makes sense. I suspect my stim time will be short as my RE has already seen how fast I responded to a fairly large dose of Follistim first try. My follicles stalled at 15 and more grew and caught up. I was on track for 15+ follicles for an IUI. So hopefully my stim time will be short and I'll get lucky.
I see my RE next Tuesday as f/u to my D&C and we are going to discuss ivf. He is aware we have met our deductible so some cost is covered and all drugs are covered 100% now so he said a week ago he was going to start ASAP with me. Wonder if I'll have to complete a normal period first?! With my 15 week loss and d&e we started as soon as my period started after my d&e so hopefully ivf stim will be the same.
Thanks for following me!! I need buddies through this process.

 

[Sophie2015]

How long it takes depends on your protocol.

My clinic sends the biopsied cells to Genesis Genetics in Michigan, the results are guaranteed within 24 hours. So you can proceed in a fresh cycle. I have never done it that way because the first time I had developed OHSS and the second time we just wanted to do the same as the first time plus we wanted to wait a bit to hopefully space the 2 kids a bit more.

I have gone straight to FET after the fresh cycle. I didn't feel like I really had to recover from the fresh cycle but my clinic also does a very long FET with Lupron Depot, so you have about 8 weeks between starting your post-IVF bleed and the transfer.

In our first transfer, we transferred 2 PGS normal embryos (both male) but only one took. So PGS isn't a guarantee of success, though the odds are way higher than with anything else.

I'm almost positive that my transfer won't be fresh. I'm in TN. Not sure where the lab is (although I think it's local) but for some reason I think my RE said the embryos would be frozen.
With my 2nd Follistim IUI cycle I developed mild OHSS after so I'm fully expecting it with my ivf. 😕

 

[3chords]

Really, 3chords? That is super interesting. My clinic uses Genesis as well but we wouldn't have gotten results for a week. I wonder if they have partner clinics that they have a quicker turn around time for.

So would they biopsy on day 5 and then transfer on day 6? Or does your clinic biopsy the embryos before blast stage? Just curious because I want to look into it more for my next cycle should I get there, didn't even have any make it that could be biopsied.

The first time around they biopsied on day 4 (morula stage) because they were hoping to transfer on day 5. You wouldn't really transfer on day 6 unless the embryos were slow growers and didn't go to blast until day 6 and even then it is problematic because your lining is no longer in sync with the embryo stage. I did a lot of research on this, really neat stuff.

This time around because we knew that we were not transferring in the fresh cycle they could biopsy on day 5.

As I understand with Genesis, there are 2 options. One is for blasts which are marked "fresh transfer" for which the turnaround is next day by noon. The other is for frozen transfer, which can take a week or two since no hurry. I asked whether we could pay a rush fee to get them done in 24 hrs during this frozen cycle and was told no, that my clinic would simply mark them as "fresh transfer" on the requisition form. Worked!

 

[BronteForever]

Wow - thanks so much for the info 3chords. I'm definetly going to ask about that because I told my clinic I didn't want to waste my fresh transfer this next round since we purchased a package and I didn't even get to attempt a transfer yet but I really want to do PGS because of age to improve chances!

I had slow growers my last cycle but none made it by day 6. So really hoping we have something we can work with this next time.

Was your clinic worried about biopsying at the morula stage?

 

[Sophie2015]

IVF with PGD may never happen. I've developed a blood clot in my left lung. Likely from my D&C 2 weeks ago. I'm in critical care receiving IV Heparin. I'm still spotting so the concern is I'll re hemorrhage while they try to treat my clot with blood thinners.
I feel like this will end my TTC days. Scared to death I'll die and devastated.

 

[BronteForever]

Sophie - oh my goodness this is so scary. Sending you the best of thoughts that you recover. Really hope they can treat the clot with blood thinners. My husband has to be on them for life and has been on heparin after heart surgery and it really does wonders. So hoping it helps clear it out. Glad it was found but what a scary thing. You are definitely in my thoughts.

 

[Sophie2015]

I'm devastated. I've been saying for years that I was clotting and my babies were dying 1st trimester. Will be interesting to see if genetics was normal for this loss. If so.... Regardless all future fertility efforts are on hold

 

[BronteForever]

You just worry about getting better and all the other stuff will work itself out. I know it's devastating though.

 

[3chords]

Oh no, I'm so sorry to hear.

I have a clotting disorder as well so I know the fear. Hang in there and give heparin a chance to work. I will keep you in my thoughts and please hang in there the best you can. It will be better soon!

 

[Sophie2015]

Heading home tomorrow on Lovenox. Hematologist says I should have always been on Lovenox and that the Follistim elevated my estrogen beyond what my baby Asa could handle and caused the clot (PE). She is committed to working with my RE to help us carry a baby. I see my RE Tuesday. Let's hope he agrees to the plan.

 

[BronteForever]

I'm glad they are sending you home with a good plan in place! Really hope the meds do the trick. So sorry again you had this happen.

 

[3chords]

Fingers crossed!

I was on Fragmin for the first two trimesters of my pregnancy. I never had it before, and I am convinced it helped keep the pregnancy going. I started the Fragmin around the time of the transfer of the embryo.

 

[Sophie2015]

Well ladies, unless something else arises I'm scheduled to start my ivf with my 2nd cycle which will likely be the beginning of November. However I'm told the process is life threatening for me because I need a therapeutic dose of Lovenox for several more months (80mg twice a day) but I will have to come off my Lovenox completely for 7-10 days around egg retrieval to prevent my ovaries from bleeding. Of course no Lovenox during the time my E2 will be at its highest is life threatening due to my clotting disorder and my most recent clotting event that I'm not fully recovered from. I have mixed emotions. I just turned 44. I can't afford to wait til next year for ivf and I'm told the same risk applies regardless of when we begin ivf- now or next year. So feeling really scared and depressed and defeated. 😔

 

[BronteForever]

Sophie - I'm so sorry you have to deal with this. This is incredibly scary. Are you wanting to proceed regardless of the risks?

Do they think the clotting disorder caused the miscarriages? If so what's would be the plan to prevent it this time around now that you know it's a clotting issue.

Lots of tough decisions ahead I'm sure. Best wishes in deciding what's best for you.