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In Vitro Fertilization and PGD

My husband and I are considering In Vitro Fertilization.  My husband has a recipricol translocation between chromosomes 11 & 22.  Basically, that means that chromosome 11 & 22 have switched places.  Thus, putting us at a high risk of having children with abnormalities and miscarriages.  I have had 2 miscarriages so far and no successful pregnancies.  We have been trying for about 2 years.  I am currently on my first round of clomid.  I will only get 3 rounds and if it does not work then we will possibly do the invitro.  Because of my husbands problem, we only have a 30% chance of having a healthy baby.  My genetics counselor is telling us that they offer something called a PGD which they do to select the healthy sperm.  My understanding is that they will first find the healthy sperm and once it has grown for a few days they will do in vitro to insert the egg into my placenta.  I am wondering if anyone else has had to do this and is in vitro painful.  I was hoping to find some statistics on the success rates based on this particular translocation.  If anyone has undergone in vetro, any details of the procedure or how you felt during and after as well as your outcome, would be very helpful to me.  Any advice or information would be appreciated.
18 Responses
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294043 tn?1354207946
PGD means that after embryos form they are being tested (not the sperm) for chromosomal abnormalities.  That way you can eliminate all chromosomal abnormalities and ensure that transferred embryos are healthy.  Ivf is not painful but it is expensive (even more expensive with PGD) and quite invasive.  Ivf success rates with embryos after PGD are higher than regular ivf.  
Good luck to you!!
Helpful - 0
552955 tn?1215192429
I tried clomid for 6 months in 2002 and again for six months in 2005. It did nothing for me at all. So we went straight to invitro when I found out that my new job covers invitro at 90% :-)

I did find parts of invitro to be painful, the shots in the stomach, implanting of the eggs, other than that it really isn't bad.  They give you a valumn to relax and acupuncture helps you with the pain as well.

I did not do acupuncture the first time and I felt awful for two weeks after the transfer, cramps, nausea, etc. Then I started on Christmas day, no fun.

We implanted four via frozen emryo transfer on June 26. I go for a pregnancy test next week. I pray that they took this time.
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Avatar universal
How many times have you done invitro?  I am a little concerned about the expense based on the fact that the success rates are not real high.  With my husbands chromosome issue, we can get pregnant.  The problem is that only 30% of his sperm is healthy therefore; we may not have a healthy pregnancy.  I would really like to find a treatment that does a selection of the sperm to determine the good from the bad.  I have gotten pregnant 2 times so far but I had a miscarriage with both of them.  With invitro, do they test the sperm?  I am not real clear on how it even works or what they do.
Helpful - 0
531467 tn?1228415363
I don't know if there's a way to test sperm.  Usually, if there are sperm issues, during IVF, they will also do ICSI (where they inject the sperm into the egg).  This allows the doctor to "pick" the best looking sperm.  Best shaped and most mobile.  After the the embryos form, you can opt to have the embryos tested before it is transferred back into you.  However, there's a risk that the embryos might not survive the test.  And there's extra cost to the test.  

The success rate of IVF depends on your age.  If you're over 37, your success rate drops below 30%.  

I'm over 37 and I've done 2 incidents of IVF.  Despite the fact that my embryos were high grades, it did not work for us :(  

I personally found the retrieval most painful and the injections.

Hope this helps.
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161938 tn?1212169149
My opinion on PGD - it is bad news - which babies will you throw away?  seriously, that is what the doctors are asking - what criteria will you "keep"  and what will you "destroy"

have you considered embryo adoption - there is a great need for parents this way - and less chance for abnormalities - it is 2-4 thousand dollars a try!
Helpful - 0
Avatar universal
If I do PGD then your saying that I would have to choose which babies to abort?  They did not explain that to me.  They just said that the they would grow outside of my body for 3 days and the doctor would only insert the healthy eggs.  They did not mention anything about having to select which babies to keep.  I can't do that.  

My husband and I discussed a sperm doner but, we decided not to take that route.  My husband feels like it would be my baby and some other mans baby and that he would always know that it was not his baby.  I respect that.  I may argue the point if there was not chance of us having a healthy baby but my doctor says that we will eventually have a healthy baby but, we may have to experience several miscarriages before it happens.  Statistically we only have a 30% chance however; because the healthy swimmers are much faster and stronger then the abnormal sperm, that brings us up to a 50/50 chance.  Those odds aren't great but they are better than 30%.  So we are hoping to have a beautiful and healthy baby that looks a little like both of us.  May sound crazy but, we both are very strongly certain that we would like to have a baby of our own.  I do wish that the IVF was around the same price as the embryo adoption.  I wonder what the difference is (rather than the chromosome studies).  I mean either way they are taking sperm from a male and using pretty much the same procedure to insert it into the female.
Helpful - 0
463339 tn?1207532884
Ok I have to interject that PGD is not a decision on which baby to abort, that is completely ridiculous.  It is embryo selection that is done by doing a biopsy on day 3 where one of eight or so blastomeres is removed and checked for chromosome composition.  Then on day 5 when the results are back, the chromosomally normal embryos are transferred back into the uterus.

In this particular case of translocation, the embryo would not develop normally and causes miscarriage so it is not like you are throwing away healthy viable embryos.  They are abnormal and would not develop into normal pregnancies.

I think this is a very reasonable option for you.  To my knowledge of andrology (which is fairly extensive) there is no way to select chromosomally normal sperm before insemination.  I think it is a technology that has not been thoroughly investigated because 97% of embryo chromosome abnormalities are due to a defect in the egg.

Whatever you decide, best of luck to you, and feel free to send me a message if you have any further questions!
Helpful - 0
Avatar universal
Thanks for the feedback.  I was really starting to think that PGD was a bad idea.  I think your are right, it does seem reasonable for us.  It is so hard, making all of these decisions.  I don't fully understand all of the procedures but, I have been reading all of the other postings and there are several abbreviations for different procedures that I don't quite get.  

Hopefully after scheduling a couseltation I will know what options are best for us.  But, I tell you, I think all of TTCers need a miracle.  

Again, thanks for your response.  It helped to ease my doubt..(I also appreciate the other response.  None of us are doctors but, I think we all just want to help each other.  And that's great!)
Helpful - 0
Avatar universal
I am sorry for your losses and the troubles with your DH's sperm. We do not have that problem, but have had 3 miscarriages and no successful pregnancy.  

PGD is only available if you do IVF, it is a way to determine if a embryo is normal before implanting.   As Lvn says, its not throwing away, its likely only one will work, plus if more, can be frozen for another attempt.  

I think its reasonable for you to consider it.  However, it won't necessarily increase your chances of a successful pregnancy.  It will increase your chances of conceiving in a cycle and help avoid a potential miscarriage (i.e., if embryos not normal they won't be implanted).  But your miscarriage rate is essentialy the same as trying on your own, just PGD means you can see before implantation whether embryo is normal.

One reason I mention this is the cost...it can be around $10K or more each time.  Although you have an additional concern with the translocation, you still have an excellent chance of conceiving again on your own.  Still, if you are worried about another miscarriage or serious birth defects, it might be the best option for you.  In my case, RE doesn't think IVF will help at this point, she simply says keep trying, even though my miscarriage rate is about 30-40%.  
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Avatar universal
Regarding your comment that it will only increase our chances in conceiving:  I have thought about that.  That is actually one reason why I am having doubts.  I called the doctor and he said that total costs with PGD will be about $13,800.00.  I keep thinking, I have not problem getting pregnant.  I mean within reason.  It has happened for us twice so far.  We have been trying for four years but, took breaks from time to time.  I am not sure that the expense would payoff considering that the only thing that the procedure is doing for me is, detecting normal sperm.  The IVF is what I am paying all of the money for and I don't necessarily need help in that area.  Still might spend all of that money for nothing.  This is a really hard decission.
Helpful - 0
161938 tn?1212169149
abort is the wrong word
you create LIVING babies and you decide which ones not to let live
that is horrible - can you live with doing that - they grow and if you don't want them you don't put them in and they are destroyed

no its not abortion - becuase they are not in your body - but it is killing them by not letting them live

I really hope you will reconsider this cruelty!
Helpful - 0
Avatar universal
My understanding is that the determine which sperm is healthy.  The abnormal "unhealthy" sperm that would not survive are the ones that they do not insert.  But, again I have not idea. That is why I posted - so that I could find out what it is.  I have not spoken to a doctor about it "in detail" yet.  We have not made a decision at this point.  We are only looking for a way to avoid miscarriages.  My genetics doctor says that we could have up to 10 or more miscarriages before ever having a healthy baby.  Or we can have a healthy baby this next pregnancy.  However, if the sperm that fertilizes the egg is unhealthy then I will have a miscarriage anyway.  So, we are leaving our options open until we get real hard facts.  I was hoping that someone on this site had already had some experience or at least some facts about PGD and what it does, that is the purpose of this forum.  

Also, I was under the impression that the healthy ones were inserted and if any were left over they were frozen and reused at a later cycle.  Again, this could be wrong - I don't understand exactly what everything means.
Helpful - 0
161938 tn?1212169149
I would ask your doctor to give you EXACT details.
PGD is not for sperm it is for embryos
Generally the docs - pick out the ones you "don't want"  and discard them (now the expert here says "oh they would have died anyway"  but that is a choice you have to personally think about - and do what works best for you)
they don't usually refreeze any that have had PGD.   My doc in california is against PGD because he says it "disturbs the quality of the embryo "  because they must remove a cell
Chance does not remember - you could have 3 in a row successful pregnancies - and you could have three miscarriages with PGD
I know someone who was pregnant with PGD and miscarried at 13 weeks - imagine the devastation - it is a science - but there is no guarantees - even with PGD
Be careful the doc doesn't try to "talk you into it"  make him give you the facts and let you make your own decisions.

I wish you the best
have you considered embryo adoption?   that may be a route for you to take if you are worried about chromosomal abnormalities
Helpful - 0
Avatar universal
I do plan on getting all of the facts before I make any decisions.  Again, this is only something that we have discussed due to an option that was thrown out from our genetics counselor at OSU medical center.  Nothing has or will be decided until we have finished our cycle of clomid.  Hopefully, we will not have to resort to PGD or invitro but, I would like to be knowledgable about all of the procedures out there.  I actually used to be a firm believer in letting things happen naturally but, now that I am in this position, I have a different view then what I used to have.  So, I don't really know what to do.  When it comes down to having no babies or getting to have one baby, I chose to have one.  I come from a big family and I've always been around kids.  I have a degree in teaching early childhood education.  Kids are what I want.  Even if it is just one, I just want to have the chance to be a mom.  You know?
Helpful - 0
161938 tn?1212169149
amy
I understand
I just sometimes feel the doctors don;t treat embryos as babies - so they skew the information - even after you get pregnant some of these fertility docs - don't act as if it is  ababy you are carrying - it is frustrating
they see PGD as disposable babies and it makes me sad
I wish you the best of luck
hope OSU is good - where do you live in Ohio?
Helpful - 0
Avatar universal
I would say do what makes you happy that is all that matters. I had and abortion with my wife then girlfriend and we regreted it. It was a mistake no excuses. Anyway we tried again and she had a miscarriage so now we are really scared. Maybe we deserve it I don't know. But all that counts is how you feel and what you think is right forget what people who judge you have to say. Usually they are not happy themselves. good luck
Helpful - 0
Avatar universal
I'm sorry to hear about your bad experiences.  I don't beleive that you deserved it.  People make mistakes.  No one can really tell you what was right or wrong with the decisions that you have made or will make.  No body truely knows your situation and they cannot put themselves in your shoes.  Some of us may beleive that things like abortion is wrong but, you know what?  I didn't use to get why people did things like In vitro and amniosentosis but, I am right here, in their shoes.  Now I completely understand.

I think that once you make a decision, as you and your wife/girlfriend did, you just have to keep looking forward.  If you have guilt about it now and you say it was a mistake then, learn from it and move on.  This may not be good advice but, it makes me sad to think that anyone beleives that they deserve to experience a miscarriage.  That is something very hard to go through.  Just remember that bad choices cannot be reversed but we can learn from them.  And it will help us to make our next choice the right choice.

Good Luck to you, I hope everything works out.  Thanks for your advice!
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Avatar universal
Yes, I live in Ohio.  This hospital is really good.  And the thing is, the doctor telling me about this procedure is not in with the hospital that they are telling me can do the PGD.  They are just opening up doors just incase we need to walk through them.  I think everything will, eventually, work out.  But I guess I will have to wait and see...
Helpful - 0
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