Dr. Potter 3 or 5 day PGD biopsy?

I have the choice to choose whether I want to do a 3 or 5 day biopsy...and dont know which to choose.  Please give me your professional opinion on this and why one would be a better choice than the other.

 

Thank you Dr. Potter.

I have done both without success & would also like to know what Dr Potter thinks.

My RE told me that the 5 day biopsy is more accurate because they can take out more than one cell because by this point they are taking out only the cells that would be making up the placenta and not taking any cells from what would be the embryo.

 

please let us know in your opinion Dr. Potter what the pro's and con's are to this.

sunflowerdream:

I have the choice to choose whether I want to do a 3 or 5 day biopsy...and dont know which to choose.  Please give me your professional opinion on this and why one would be a better choice than the other.

 

Thank you Dr. Potter.

It depends on who is doing it and how the cells are going to be analyzed (FISH, CGH, WGA, etc.) I would say that at 99% of clinics you would be better of with a day 3 biopsy and a fresh transfer.

It would be a FISH analysis.  Could you further elaborate as to why the 3 day biopsy would be better just so I can understand the pros' and con's better to having a day 5 biopsy.  Thank you.

sunflowerdream:

It would be a FISH analysis.  Could you further elaborate as to why the 3 day biopsy would be better just so I can understand the pros' and con's better to having a day 5 biopsy.  Thank you.

Using the FISH technique, there is a very high rate of aneuploidy (too many or too chromosomes) because the cells are often multinucleated. Day 5 is much better with WGA (e.g. GSN) or CGH

Dr. Potter:

sunflowerdream:

Using the FISH technique, there is a very high rate of aneuploidy (too many or too chromosomes) because the cells are often multinucleated. Day 5 is much better with WGA (e.g. GSN) or CGH

 

Dr. Potter--

Can you please elaborate on what you mean by the FISH technique having a very high rate of aneuploidy?  I had 2-probe PGD done last July with my IVF cycle at HRC (by you), I haven't done any prenatal testing for aneuploidy (on bedrest during my window for the nuchal scan) and I refuse to do just the blood test as I had a false-positive in the past with the boys and it caused too much stress. So, I've decided not to do anything other than my ultrasounds (I've had quite a few with all the complications).

I'm now wondering why my 2-probe PGD would have a higher rate of aneuploidy... is that what you are saying? I assumed the 2-probe PGD was FISH. 

Sorry, I'm confused and would like some clarification by what you meant here.

Thanks for advance for answering!

Laura

Dr. Potter I am very confused as well by what you are saying?  How high exactly is the aneuplody rate using FISH doing a 3 day biopsy with a 5 probe PGD vs. doing a 5 day biopsy with a 5 probe PGD? My RE keeps telling me that doing the 5 day PGD biopsy with the 6 day embryo transfer reduces aneuplody greatly because there are more cells to analyze.???  I am just wondering why I dont see many other clinics performing the 5 day PGD biopsy?

 

Thank You.

Where you are going, they peirce the embryo on day 3 with the laser and then pull the cells from the outer layer that becomes the placenta, they do not take cells from inside the embryo, atleast that was the way it was explained to me.  So, they can take multiple cells and cross check them.  It's like the larger place in Australia that does day 5 PGD. 

Dr. Potter:

Day 5 is much better with WGA (e.g. GSN) or CGH

Is Day 5 PGD something HRC may offer in the future for patients who are opting for GSN? (and if so do you know when?)

Thank you.

Hi sunflower dream

 Where are you cycling if you don't mind me asking? I really want to do a 5 day biopsy as it just feels instinctively better to me to take cells from the part of the blastocyst that will form the placenta, than those which could form part of the baby. Thanks in advance.

 And does anyone else know what the Australian clinic is called that does a 5 day biopsy?

 

I just pm you .

jessicaellie:

Hi sunflower dream

 Where are you cycling if you don't mind me asking? I really want to do a 5 day biopsy as it just feels instinctively better to me to take cells from the part of the blastocyst that will form the placenta, than those which could form part of the baby. Thanks in advance.

 And does anyone else know what the Australian clinic is called that does a 5 day biopsy?

 

Sydney IVF does day 5 biopsies.  The cells biopsied on day 3 are not the cells that will become the baby.  What part of the baby are they telling you is being biopsied? The babies formed from embryos biopsied on day 3 are not missing anything.   The truth is that each cell at the day 3 stage has the potential to form a complete human being.  The cells have not differentiated.  The potential advantage of a day 5 biopsy is that there are more cells to analyze, potentially improving accuracy (unless they are doing FISH).  The disadvantage at this time is that reliable PGD will take longer to perform and the embryos are frozen will you wait for the results.