Why I chose to do PGT testing on my embryos: the story
I want to share my experience with PGT, why we chose to do PGT testing on our embryos and the factors that played into that decision. In case you missed it, check out part one of this post, “Why I chose to do PGT testing on my embryos: the summary”.
Our situation
We didn’t have specifics to test for with PGT-M; our only known family diseases are ones that would fall into PGT-P, which isn’t available in the UK. In fact, not only is it not available here, it’s not even legal.
There are very strict laws around genetic testing in the United Kingdom, which are enforced by the HFEA: the Human Fertilization & Embryology Association. The HFEA are involved with every IVF lab in the UK, and are supported by charging a fee of £85 for every cycle of IVF/FET! Just another thing to add to the long list of infertility costs.
In America there are less strict rules about genetic embryo testing so some clinics will offer PGT-P. Had it been available to us I think we would have used PGT-P to avoid Type 1 diabetes and mental health disorders which we have some family history of.
Our doctor and embryology lab seemed to assume that we would go with PGT-A testing, which really caught us off guard. While “safe”, there are risks involved when biopsying an embryo and the testing is quite expensive! From our research, it seems PGT is strongly recommended when the mother (or person who’s eggs are being used) is 35 or older. I wasn’t 35 yet so we didn’t fall into this category.
Our decision
Ultimately our biggest concern was the risk of miscarriage. Like any couple struggling with infertility we have dealt with so many setbacks and disappointments. If we could choose to reduce the rate of miscarriage, we would be protecting ourselves from the pain of loss; protecting ourselves from failed transfers with unknown causes. Miscarriage can also add considerable length to your TTC timeline: miscarriage can happen at any point during pregnancy (though most common before week 12) and it can take MONTHS for HCG (the pregnancy hormone) to leave your body, which is needed before trying again.
So we knew we wanted to use PGT on our embryos, and finalized that decision as we awaited our day 5 embryo results. For anyone who has survived the embryo hunger games after an egg retrieval knows, this is truly the hardest part mentally. It is brutal to see those numbers drop from egg collection, fertilization, day 3 embryo report, and day 5 blastocyst report. Because of the cost of PGT (it was ~£3,400 for us!) we had a number of embryos in mind that we wanted if we were to pay for PGT. It was a very close call (with a few embryos making “blast” on day 6!) but our final blastocyst count was exactly the number we wanted before deciding to PGT test.
It took about 10 days for our results to come in - this can take up to several weeks at some clinics! Because we used PGT-A, we knew the results would be for euploid, aneuploid, or mosaic. In America (and a few other countries) you can find out the gender of your embryos, since investigation of chromosomes will show if an embryo is an XX (female) or XY (male). This is, again, something that is illegal in the United Kingdom.
I was actually a little relieved to not know the genders of our embryos- I didn’t want to feel sad if it turned out we had all one gender or if I had a failed transfer of my only male embryo, etc. Even knowing the gender of an embryo when transferring it means that you feel a little more attached to the outcome! While I know most parents would be happy to have a healthy child of any gender, you can’t deny that gender disappointment does crop up in unexpected ways. I imagine when I am pregnant I’ll want to know the gender of the baby but knowing before transfer is too much information, in my opinion!
Our outcome
When our results came back we had 75% euploid embryos and 25% low level mosaics. This meant that all our embryos were suitable for transfer! We were quite honestly shocked at this outcome. We had a big attrition rate of fertilized embryos to blasts but the ones that made it to day 5 were strong little embryos.
Mosaic embryos are a whole discussion of their own, and one I need to approach with the guidance of a genetic counselor. But I’m very thankful to have the results we do, no matter the outcome.
While we had a really positive outcome (no aneuploids!), I am still glad we used PGT testing on our embryos. It has given us peace of mind that our embryos are as strong as we could hope and allowed us to focus on other types of preimplantation testing as we work towards a successful pregnancy. Had our outcome been different, I would have started preparing for another egg retrieval. Knowing our embryos are genetically normal gives a little reassurance that the success rate might be higher than with untested embryos.
Have you used PGT testing on your embryos? How did your decision making vary? Let me know in the comments.
