Hi -
I'm a little over 8 weeks, but we found out a couple of days ago that the embryo died about a week ago. I'm scheduled for a D&C next Monday (my request). Here's my question:
I thought my doc would be able to examine the products of conception and confirm whether or not the demise was caused by chromosomal abnormalities? This is very important to me as my lest pregnancy ended the same way at about the same time (though it was about 6 years ago). To my surprise my doc said the embryo was too small and it's heart had stopped beating too long ago to do any meaningful analysis, and to just assume it was a chromosomal problems (I know it likely was).
I also asked her about PGD testing of our embryos prior to ET for our next go-round, but she said they don't do it very often.
I trust this lady a lot and really like our clinic, but I want to do everything possible to research our best options before our next try. My insurance will only cover one more attempt and the big question is do we try with my eggs again or with a donor's eggs?
Anybody gone through testing related to any of this (post D&C, genetic testing, and/or PGD)? Any recommendations?
Anybody gone through post D&C or genetic testing, and/or
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txpacotaco
- Member
- Posts: 42
- Joined: Thu Oct 12, 2006 12:55 am
- Location: Austin, Texas, USA
Anybody gone through post D&C or genetic testing, and/or
Me: 40 - Asherman's, Polyps; DH: 42 Varicocele
1st IVF: BFP - lost @ 8 weeks
1st IVF: BFP - lost @ 8 weeks
First, I'm so sorry for your loss. Having been through this, I know the absolute pain and heart ache and how unfair it feels to get through the IVF with a BFP and then have this happen. My thoughts and prayers are with you.
I had a chromosomal analysis after my D&C in April. The baby's heart stopped beating also (on the first scan, the heart beat was lower than it should have been, the second scan showed it was strong again, but by the 3rd it had stopped). I was about 7- 8 weeks when it stopped (there was no way to know for sure when the heart had stopped, but the scan size showed I was about 7.5 weeks). I can still remember the trauma of watching the doctor do the third ultrasound, thinking confidently that we were 'out of the woods' with the second scan, and then having our doctor say he couldn't find the heart beat any more.
It is not 'standard' to do chromosomal analysis after a first m/c, but since we pay so much to get pregnant in the first place, I think they agreed to do it because we needed to understand if there was some other cause. It is very expensive, but my insurance covered it, thank goodness. It was hard (emotionally) to get the results (it tells you the sex of the baby) but we were able to find out that it was caused by trisomy 14 (an extra #14 chromosome) and the doctor reassured us that there was nothing we could have done and trisomy 14 is always fatal prior to birth. The lab director also told us that trimsomy 14 is much less likely to re-occur, so that was reassuring also. All in all, I was very glad we did it.
After that, on my second attempt we were going to try and do PGD. But, the second day after ER, the lab director called and encouraged us not too. He said with the number of embryo's we had at that point that were progressing, the PGD process might have resulted in nothing to transfer and there's some risk of false positive - meaning they'd exclude an embryo from the testing that might really be okay, but didn't 'pass' PGD. So, we went ahead and transferred all 5 viable embryo's at that point, but still got a negative result. I still question whether we should have gone ahead and pushed for the PGD. Yes, we might have gotten nothing to transfer, but we would have known that before transferring embryo's that might have failed because of genetic problems instead of waiting 2 weeks to get the negative beta. That said, my RE doesn't want to do PGD this time either because he wants to transfer my embies as soon as possible. I suspect their lab might not be so great at holding embies through the blast stage (stage 5) but I don't know that for a fact. Just a guess. There are all of those considerations, though.
I don't think there's any real 'right answer'. You and DH need to weigh all your options. I truly wish you all the best in facing these tough choices. Again, I'm so very sorry you've had to face this and my thoughts and prayers are with you. Take care of yourself.
- Suzhan
I had a chromosomal analysis after my D&C in April. The baby's heart stopped beating also (on the first scan, the heart beat was lower than it should have been, the second scan showed it was strong again, but by the 3rd it had stopped). I was about 7- 8 weeks when it stopped (there was no way to know for sure when the heart had stopped, but the scan size showed I was about 7.5 weeks). I can still remember the trauma of watching the doctor do the third ultrasound, thinking confidently that we were 'out of the woods' with the second scan, and then having our doctor say he couldn't find the heart beat any more.
It is not 'standard' to do chromosomal analysis after a first m/c, but since we pay so much to get pregnant in the first place, I think they agreed to do it because we needed to understand if there was some other cause. It is very expensive, but my insurance covered it, thank goodness. It was hard (emotionally) to get the results (it tells you the sex of the baby) but we were able to find out that it was caused by trisomy 14 (an extra #14 chromosome) and the doctor reassured us that there was nothing we could have done and trisomy 14 is always fatal prior to birth. The lab director also told us that trimsomy 14 is much less likely to re-occur, so that was reassuring also. All in all, I was very glad we did it.
After that, on my second attempt we were going to try and do PGD. But, the second day after ER, the lab director called and encouraged us not too. He said with the number of embryo's we had at that point that were progressing, the PGD process might have resulted in nothing to transfer and there's some risk of false positive - meaning they'd exclude an embryo from the testing that might really be okay, but didn't 'pass' PGD. So, we went ahead and transferred all 5 viable embryo's at that point, but still got a negative result. I still question whether we should have gone ahead and pushed for the PGD. Yes, we might have gotten nothing to transfer, but we would have known that before transferring embryo's that might have failed because of genetic problems instead of waiting 2 weeks to get the negative beta. That said, my RE doesn't want to do PGD this time either because he wants to transfer my embies as soon as possible. I suspect their lab might not be so great at holding embies through the blast stage (stage 5) but I don't know that for a fact. Just a guess. There are all of those considerations, though.
I don't think there's any real 'right answer'. You and DH need to weigh all your options. I truly wish you all the best in facing these tough choices. Again, I'm so very sorry you've had to face this and my thoughts and prayers are with you. Take care of yourself.
- Suzhan
txpacotaco so sorry for your loss, I think you should defenitelly ask your doctor to provide you with some answers....
Susan,
I asked my doctor to perform genetic testing on my embryos as well, but she said we dont' need too. I got this expression, that for some reason, they are very relactand to do it. Why, I wonder... Besides the cost ( I heard it is very expensive as well) what other reason might be...
Susan,
I asked my doctor to perform genetic testing on my embryos as well, but she said we dont' need too. I got this expression, that for some reason, they are very relactand to do it. Why, I wonder... Besides the cost ( I heard it is very expensive as well) what other reason might be...
Cost is one issue, but if your clinic charges you for it, I don't think they should make that decision for you - it's your choice.
However, I think the other big issue is skill of the lab in bringing embies through to day 5 (and/or opinions of some REs that day 3 transfers are better.) Overall, unless you have a real risk of genetic/chromosomal problems, they don't recommend it. At least that's my guess, but again, I think it's not their decision to make.
However, I think the other big issue is skill of the lab in bringing embies through to day 5 (and/or opinions of some REs that day 3 transfers are better.) Overall, unless you have a real risk of genetic/chromosomal problems, they don't recommend it. At least that's my guess, but again, I think it's not their decision to make.
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txpacotaco
- Member
- Posts: 42
- Joined: Thu Oct 12, 2006 12:55 am
- Location: Austin, Texas, USA
What a great picture!!!!
I've read about PGD and my impression is that it requires tremendous skill and experience; since it's such a new type of testing that probably means that not a lot of labs around the country have done much of it.
My RE explained that they normally only do PGD if the woman is older (I certainly meet that criteria) but has a lot of fertilized eggs - she said something on the order of 14, for instance. I had 12 eggs but only 6 made it to the second day and none had reached 8 cells by day 3 (we transferred 5 on day 3). She also mentioned that there is a risk in extracting a single cell from an embryo at that stage, which I understand.
I read a great book over the past couple of days called "Miscarriage - why it happens and how best to reduce your risks" by Henry M Lerner, MD, OB/GYN. It explains exactly how, why, and when chromosomal abnormalities occur.
I understand that there's really nothing we can do to prevent this type of miscarriage from occurring. I guess I'm just looking for any information of any kind - it might be useful in the future, I just don't know.
It's weird. The last time this happened I was single and not trying to get pregnant though, at 34, was happy to find out I was - but I was absolutely devastated for months after it ended. I was also alone. This time I'm married to the most wonderful man - someone I waited literally all my life for - and we've tried so hard to get pregnant and oh my gosh how I want to have children with him - to see a reflection of him (and me) in these wonderful people I know we can make and pass life on to.... and yet I don't feel anything except a little concerned that I'm not feeling more. I don't even feel numb. I just feel like... ok, on to the next thing, that's that. I wonder when this is going to hit me, or if it even is, and why I'm not hurting. Maybe it's partially because I don't want this journey to be a painful experience for DH (or me) - just a joyful path to parenthood. I just don't get it.
Of course, it'll probably really hit me when I wake up from the D&C. I hope not.
Thank you for sharing your info. If you think of anything else please let me know and good luck on your own journeys through this stuff.
Rachel
I've read about PGD and my impression is that it requires tremendous skill and experience; since it's such a new type of testing that probably means that not a lot of labs around the country have done much of it.
My RE explained that they normally only do PGD if the woman is older (I certainly meet that criteria) but has a lot of fertilized eggs - she said something on the order of 14, for instance. I had 12 eggs but only 6 made it to the second day and none had reached 8 cells by day 3 (we transferred 5 on day 3). She also mentioned that there is a risk in extracting a single cell from an embryo at that stage, which I understand.
I read a great book over the past couple of days called "Miscarriage - why it happens and how best to reduce your risks" by Henry M Lerner, MD, OB/GYN. It explains exactly how, why, and when chromosomal abnormalities occur.
I understand that there's really nothing we can do to prevent this type of miscarriage from occurring. I guess I'm just looking for any information of any kind - it might be useful in the future, I just don't know.
It's weird. The last time this happened I was single and not trying to get pregnant though, at 34, was happy to find out I was - but I was absolutely devastated for months after it ended. I was also alone. This time I'm married to the most wonderful man - someone I waited literally all my life for - and we've tried so hard to get pregnant and oh my gosh how I want to have children with him - to see a reflection of him (and me) in these wonderful people I know we can make and pass life on to.... and yet I don't feel anything except a little concerned that I'm not feeling more. I don't even feel numb. I just feel like... ok, on to the next thing, that's that. I wonder when this is going to hit me, or if it even is, and why I'm not hurting. Maybe it's partially because I don't want this journey to be a painful experience for DH (or me) - just a joyful path to parenthood. I just don't get it.
Of course, it'll probably really hit me when I wake up from the D&C. I hope not.
Thank you for sharing your info. If you think of anything else please let me know and good luck on your own journeys through this stuff.
Rachel
Me: 40 - Asherman's, Polyps; DH: 42 Varicocele
1st IVF: BFP - lost @ 8 weeks
1st IVF: BFP - lost @ 8 weeks
I hope you've recovered from your d & c ok. I am so sorry for your loss. I know how you feel. Today is 1 year since we found our by us that our babys heart stopped at 9 weeks. I too had a d & c after & I definitely had roller coaster emotions so, be prepared. I told the Dr. that we wanted every test done on the fetus possible & they did them. I actually hoped that it was a chromosome problem because it was my 3rd ivf cycle but, my first donor cycle & I knew that if it was chromosomal then it wasn't related to something faulty in my body. The tests came back as a "normal" baby girl. I have heard about pgt & I heard it is quite expensive. I do think that we need to take charge of our health care & that Drs don't know everything. If it is something important to you & you can afford it then find a Dr that respects your wishes. I have found that some Drs don't want to do certain tests because they don't have experience with it or it's inconvenient. I have 3 children with my husband & have unexplained infertility for almost 10 years. I have had 3 failed ivf cycles. I wil be using donors again in Jan. because this too will probably be my last cycle & we don't know where our problem lies. It has taken me this long to get past the mental exhaustion. I would suggest that for you let yourself rest physically & mentally. When you are prepared for your next cycle I would definitely consider a donor or even pgt. Keeping in mind that your chances of pregancy goes up significantly with a donor. It may cost more but if it's you last try why not do everything in your power to make it work! Best of luck to you!
Pixiesmom
Pixiesmom
Hi Rachel
I'm so sorry for the loss of your baby...
I just wanted to tell you that my doc suggests using donor eggs. I'm 40 like you and he said the eggs become abnormal at age 35. I had good responses throughout my whole cycle, so it was a shock that none out of three transferred embryos didn't implant, and the doc said he couldn't understand it either. So it must be the age of my eggs. I'm seriously thinking about donor embryos as opposed to donor eggs though. To me, that would be the same as adoption, only I'd get to carry the baby.
About you not feeling anything emotionally... it's weird isn't it? And then the fact that you have the perfect husband now and really want to be parents... it's just crazy how things work out. I really hope you'll be successful next time.
I remember on one of your other posts, you were thinking about complaining to the board about the treatment you received. How did all of that turn out?
Good luck on your D&C tomorrow. Take care.
Leslie
I'm so sorry for the loss of your baby...
I just wanted to tell you that my doc suggests using donor eggs. I'm 40 like you and he said the eggs become abnormal at age 35. I had good responses throughout my whole cycle, so it was a shock that none out of three transferred embryos didn't implant, and the doc said he couldn't understand it either. So it must be the age of my eggs. I'm seriously thinking about donor embryos as opposed to donor eggs though. To me, that would be the same as adoption, only I'd get to carry the baby.
About you not feeling anything emotionally... it's weird isn't it? And then the fact that you have the perfect husband now and really want to be parents... it's just crazy how things work out. I really hope you'll be successful next time.
I remember on one of your other posts, you were thinking about complaining to the board about the treatment you received. How did all of that turn out?
Good luck on your D&C tomorrow. Take care.
Leslie