Need Some Advice


#1

I posted this in another thread, but did not get any responses. I’m meeting with RE on Monday and was hoping to have all my thoughts collected.

I just found out today I had a chemical pregnancy. We are going to do IVF in January and not sure what we should do differently.

I don’t know if we should change RE. I did get pregnant with 2nd IVF in 2009 with the current RE and have a wonderful son. For that IVF my RE told my husband that my eggs were not of best quality and I was shocked when we became pregnant.

With the last two IVF and recent FET all the embryos were aCGH genetic tested prior to transfer. I was very hesitant with genetic testing as it can possibly decrease pregnancy rates. However, my RE was insistent because his own wife who had miscarriages used it and now she is pregnant. In addition, the lab does a large volume of genetic testing and are better skilled than most labs out there, so they report.

I’m also surprised to have a chemical pregnancy with normal genetic tested embryos.

Now my RE is recommending not using genetic testing as this maybe the reason for my not getting pregnant. My only hesitation is that with the genetic testing we identified 40-50% abnormal embryos. I’m not sure what to do.

Anyone have any thoughts about the above and what I can do differently. Should I change RE, I did get pregnant with him in 2009.

Also, I have been doing acupuncture 2x/weekly since the beginning of September 2011, which I didn’t do with my first pregnancy.

Thanks for your thoughts.


#2

[quote=Optimistic02]I posted this in another thread, but did not get any responses. I’m meeting with RE on Monday and was hoping to have all my thoughts collected.

I just found out today I had a chemical pregnancy. We are going to do IVF in January and not sure what we should do differently.

I don’t know if we should change RE. I did get pregnant with 2nd IVF in 2009 with the current RE and have a wonderful son. For that IVF my RE told my husband that my eggs were not of best quality and I was shocked when we became pregnant.

With the last two IVF and recent FET all the embryos were aCGH genetic tested prior to transfer. I was very hesitant with genetic testing as it can possibly decrease pregnancy rates. However, my RE was insistent because his own wife who had miscarriages used it and now she is pregnant. In addition, the lab does a large volume of genetic testing and are better skilled than most labs out there, so they report.

I’m also surprised to have a chemical pregnancy with normal genetic tested embryos.

Now my RE is recommending not using genetic testing as this maybe the reason for my not getting pregnant. My only hesitation is that with the genetic testing we identified 40-50% abnormal embryos. I’m not sure what to do.

Anyone have any thoughts about the above and what I can do differently. Should I change RE, I did get pregnant with him in 2009.

Also, I have been doing acupuncture 2x/weekly since the beginning of September 2011, which I didn’t do with my first pregnancy.

Thanks for your thoughts.[/quote]

I am so sorry for your chemical pregnancy. I really don’t have any advice on whether you should do the genetic testing, but I doubt that was the cause of your chemical. Of course i can’t be sure, but I have had 3 chemical pregnancies this year with no genetic testing. My first two were with frozen embryos (slow frozen in 09) and I chalked it up to bad embryos - but I did add in lovenox and have a hysteroscopy and D&C. I still had another chemical with my fresh cycle. I have no idea if it is an implantation issue due to immune issues, structural problems, or embryo quality. Sadly, there is no way to ever know. I wish you the best of luck in your next cycle.


#3

[quote=Optimistic02]I posted this in another thread, but did not get any responses. I’m meeting with RE on Monday and was hoping to have all my thoughts collected.

I just found out today I had a chemical pregnancy. We are going to do IVF in January and not sure what we should do differently.

I don’t know if we should change RE. I did get pregnant with 2nd IVF in 2009 with the current RE and have a wonderful son. For that IVF my RE told my husband that my eggs were not of best quality and I was shocked when we became pregnant.

With the last two IVF and recent FET all the embryos were aCGH genetic tested prior to transfer. I was very hesitant with genetic testing as it can possibly decrease pregnancy rates. However, my RE was insistent because his own wife who had miscarriages used it and now she is pregnant. In addition, the lab does a large volume of genetic testing and are better skilled than most labs out there, so they report.

I’m also surprised to have a chemical pregnancy with normal genetic tested embryos.

Now my RE is recommending not using genetic testing as this maybe the reason for my not getting pregnant. My only hesitation is that with the genetic testing we identified 40-50% abnormal embryos. I’m not sure what to do.

Anyone have any thoughts about the above and what I can do differently. Should I change RE, I did get pregnant with him in 2009.

Also, I have been doing acupuncture 2x/weekly since the beginning of September 2011, which I didn’t do with my first pregnancy.

Thanks for your thoughts.[/quote]

If they were biopsied at the blastocyst stage, then the biopsy probably did not harm them much, and probably had nothing to do with your chemical pregnancy. More likely causes are poor embryo morphology or damage from freezing.


#4

Thanks ladies for your support.

MaryEvelyn: So sorry to hear about three chemical pregnancies. Are you planning on another IVF?


#5

I agree with Ghost. Blast biopsy is unlikely to have damaged your embryo. If you did Day 3 biopsy and fresh Day 5 transfer, you might want to consider Day 5 with FET instead just in case it was embryo damage.

I wouldn’t switch REs over a chemical, personally. They got your embryos to a stage where they could implant. They can’t fix the embryo quality. Something to remember with aCGH testing for anueploidy is that it just looks at the number of chromosomes, it doesn’t find every possible genetic issue. There can still be something wrong on one of the chromosomes that could cause a miscarriage, and people do also miscarry genetically normal embryos sometimes.

I personally did IVF just to do the aCGH testing, and I think if you are over about 37, it gives you a much better chance of getting pregnant and having a baby. Otherwise, as you say, 50% abnormal embryos is pretty typical at that age, and I know from personal experience that they can stick for quite a while, which loses you a lot of time that you don’t have if you are a bit older.

There are a lot of us who have done/are doing testing over in this thread, and it’s a wonderful, supportive group if you’d like to join us: http://forums.fertilitycommunity.com/vitro-fertilization-ivf/2020195546-er-pgd-fet-girls.html


#6

[quote=Optimistic02]Thanks ladies for your support.

MaryEvelyn: So sorry to hear about three chemical pregnancies. Are you planning on another IVF?[/quote]

Thanks. So sorry for you as well.

We are done with the assisted procedures. All out of money. We will try on our own, but don’t expect to have much luck with that.


#7

Thanks so much for your reply.

Both were blastocyst on transfer, one was a day 3 aCGH and other was a day 5 aCGH. We are lucky to have a facility that can do a blastocyst aCGH and have results within 24hrs. for a 6 day transfer.

The reason for possibly changing RE was not that we had a chemical, but to have a new set of eyes review my chart. My RE has his shortcomings terrible bedside manners and does not take the time-out to discuss things when initial plans change, but he is still a very good doctor.

We were planning on doing aCGH again, but my RE doesn’t want to do it. I think after getting a BFP with a morula and a cavitated blast he wants to try without. We have a meeting with him on Mon.


#8

[QUOTE=kimberf]I agree with Ghost. Blast biopsy is unlikely to have damaged your embryo. If you did Day 3 biopsy and fresh Day 5 transfer, you might want to consider Day 5 with FET instead just in case it was embryo damage.

I wouldn’t switch REs over a chemical, personally. They got your embryos to a stage where they could implant. They can’t fix the embryo quality. Something to remember with aCGH testing for anueploidy is that it just looks at the number of chromosomes, it doesn’t find every possible genetic issue. There can still be something wrong on one of the chromosomes that could cause a miscarriage, and people do also miscarry genetically normal embryos sometimes.

I personally did IVF just to do the aCGH testing, and I think if you are over about 37, it gives you a much better chance of getting pregnant and having a baby. Otherwise, as you say, 50% abnormal embryos is pretty typical at that age, and I know from personal experience that they can stick for quite a while, which loses you a lot of time that you don’t have if you are a bit older.

There are a lot of us who have done/are doing testing over in this thread, and it’s a wonderful, supportive group if you’d like to join us: http://forums.fertilitycommunity.com/vitro-fertilization-ivf/2020195546-er-pgd-fet-girls.html[/QUOTE]

Thanks so much for your reply.

Both were blastocyst on transfer, one was a day 3 aCGH and other was a day 5 aCGH. We are lucky to have a facility that can do a blastocyst aCGH and have results within 24hrs. for a 6 day transfer.

The reason for possibly changing RE was not that we had a chemical, but to have a new set of eyes review my chart. My RE has his shortcomings terrible bedside manners and does not take the time-out to discuss things when initial plans change, but he is still a very good doctor.

We were planning on doing aCGH again, but my RE doesn’t want to do it. I think after getting a BFP with a morula and a cavitated blast he wants to try without. We have a meeting with him on Mon.


#9

Does your current RE have the best stats in your area? Have you checked on SART? That would be the deciding factor for me…success. Who cares how nice he is, just if he can get it to work.
I was reading my clinic’s website last night. It said they do genetic testing and put back 2 embies OR they put back 4 untested embies, for women age 40 and up. I was like “wow 4 embies!”, but I guess that compensates for genetically abnormal ones because they will either not implant or be lost early on. Just a thought. How many does your RE plan to put back if you skip the testing?


#10

[QUOTE=luv4rachela]Does your current RE have the best stats in your area? Have you checked on SART? That would be the deciding factor for me…success. Who cares how nice he is, just if he can get it to work.
I was reading my clinic’s website last night. It said they do genetic testing and put back 2 embies OR they put back 4 untested embies, for women age 40 and up. I was like “wow 4 embies!”, but I guess that compensates for genetically abnormal ones because they will either not implant or be lost early on. Just a thought. How many does your RE plan to put back if you skip the testing?[/QUOTE]
I have looked on SART the stats are based on clinic not clinician, which is unfortunate.

When I did get pregnant in 2010 we transferred 2 unfortunately one split and we had triplets. My RE didnt think it was a big deal and recommened reduction. I wanted to be greedy, but they warned me about losing all three and strongly recommended against keeping the maternal twins. We reduced and we have a healthy boy. The decision still haunts me.

I know my RE would be okay with transferring three. I think I would be okay with it as well based on being unsuccessful the last few months. I just would hate to put ourselves in that situation again.

Thanks for your thoughts this will help us when we have our meeting with him on Mon.


#11

Just wanted to say that this is not always the case. If you check that PGD thread I mentioned, there are several of us who have had second trimester losses. For me, it was absolutely devastating, not to mention the fact that it lost me about 6 months of time between being pregnant, waiting for hCG to zero out, get my period, etc. If it were the case that abnormal embryos would just not implant or would be chemicals/early miscarriages, sure, but that’s not always what happens.

If you think a second set of eyes would help, then I’d say why not try a consult with someone else. I wouldn’t do it over bedside manner, but you might get fresh ideas. I’m kind of surprised to see your RE saying not to test again next time, since it seems like more clinics are starting to do more testing for those of us who are a little older. The way I see it, you at least got a BFP with one of them, so it certainly didn’t hurt.

That’s awesome that your clinic can do the one-day turnaround on Day 5 biopsy. Are you at RMANJ?


#12

[QUOTE=kimberf]Just wanted to say that this is not always the case. If you check that PGD thread I mentioned, there are several of us who have had second trimester losses. For me, it was absolutely devastating, not to mention the fact that it lost me about 6 months of time between being pregnant, waiting for hCG to zero out, get my period, etc. If it were the case that abnormal embryos would just not implant or would be chemicals/early miscarriages, sure, but that’s not always what happens.

If you think a second set of eyes would help, then I’d say why not try a consult with someone else. I wouldn’t do it over bedside manner, but you might get fresh ideas. I’m kind of surprised to see your RE saying not to test again next time, since it seems like more clinics are starting to do more testing for those of us who are a little older. The way I see it, you at least got a BFP with one of them, so it certainly didn’t hurt.

That’s awesome that your clinic can do the one-day turnaround on Day 5 biopsy. Are you at RMANJ?[/QUOTE]

Thank you so much for sharing your experience.

This is definitely a big concern of ours. Getting pregnant then having a miscarriage and losing time we don’t have. I’m interested in hearing his thoughts, I will know better on Monday.

I’m at SCRC there is a Reprogenetics lab that opened up very close to the practice.

Maybe we will still do the testing and transfer 3, but this comes with its own bag of risks.


#13

I can’t offer a ton of advice but I pray you find your answers. I struggled with deciding to switch REs after our awful first cycle. But I stuck with him for the second cycle and it was worlds different. Sometimes I don’t think it’s not the REs fault but just plain science/luck. You could post on the SIRM west blog and ask a doctor to give advice. Then you can see what another dr would do in a casual way. Maybe you could phone conference with some different REs and just see what they would do differently. Again, :grouphug: and hope you find your answers :slight_smile:


#14

[QUOTE=buckeyegirl918]I can’t offer a ton of advice but I pray you find your answers. I struggled with deciding to switch REs after our awful first cycle. But I stuck with him for the second cycle and it was worlds different. Sometimes I don’t think it’s not the REs fault but just plain science/luck. You could post on the SIRM west blog and ask a doctor to give advice. Then you can see what another dr would do in a casual way. Maybe you could phone conference with some different REs and just see what they would do differently. Again, :grouphug: and hope you find your answers :)[/QUOTE]

First congratulations on your BFP!!!

Thanks for your support and input. We are meeting with our RE tomorrow hopefully, it will help us make some decisions. We are not eager to change RE, but just want one of the other doctors at the practice to review and see if they have any input.