PGS Consult

Sorry gang, this one might be a boring one but I'm mainly posting so I can remember everything we talked about yesterday with the woman from the genetic testing facility.

First things first, the cost for testing 8 embryos is $1875. This is just the testing and my clinic's embryologists will have a separate charge of up to $1500 for the biopsy portion for a grand total of $3375 out of pocket. I'm pretty sure none of this will be covered by insurance but I'll try to submit it anyway if we go this route.  If we only have 2 embryos make it to day 5 we can decide to stim again, then I can send any additional embryos to the facility all in one batch and as long as we don't go over 8 - that's the charge. 

Conducting PGS on day 5 embryos is less risky to the embryo and more accurate in terms of getting results the lab can be confident in. Now they can't tell me if we'll have any genetic disorders aside from extra or missing chromosomes. That's all they test.

Results are in within 5 business days so there's no chance of doing a day 6 transfer with tested embryos. My RE mentioned this option on the phone after one of my failed cycles so I'll have to find  out what's up. I'm not sure if they're using another company or what. 

My RE will get the results and then he'll relay them to me. There are 3 categories of results I could get: normal, abnormal and no result. The first 2 are pretty self explanatory but the no result category happens about 5% of the time and is due to the fact that not enough DNA was biopsied.  If we wish to retest, my clinic would have to thaw the embryo, test it, and then refreeze it. Seems like a lot, right? Oh and that's not counting the fact that when we would want to transfer it would have to be re-thawed as well. I'm not keen on that idea. The upside - there is no charge to retest the embryo.

There's also a 4% chance that even with a day 5 embryo, the biopsied cells might not be representative of the entire embryo (called mosaic). So the cells they biopsied could be abnormal but the rest of the embryo could be normal or vice versa.

Damage from the biopsy only happens in 1% of the cases but is necessarily a function of skill and experience of the embryologist. Yikes - love leaving stuff this important to human error, right?

When the results come back, the lab will tell us how confident they are about each of their decisions on the embryos. Below 75% confidence will be counted as "do not transfer" and above that will be counted toward "transfer recommended." So even if there are some normal embryos and if for some reason the lab isn't all that confident in their testing, we could be looking at a do not transfer embryo.

So after the consult, E and I talked. I feel torn because I already feel like we're taking so many chances with science here and to mess with things further might not be such a good idea.  There are so many variables to consider and what I'm most afraid of is getting incorrect results, damaging embryos and the fact that there's no long term research on the children born form PGS tested embryos.

I don't think I'll be able to make a decision on this until we see how many embryos we're working with. If we've got a big batch, then I'm more inclined to test because we have resolved to transfer every embryo we create. But if we're talking 3 or less, then I might be more inclined to leave well enough alone and just risk it.  Like I had said before, my ideal situation would be to "pick" the best embryo for a fresh transfer on day 5 and then test any other ones. That seems to be the best of both worlds and the only way I might feel confident in our decision to use PGS.