Mosaicism and other genetic stuff

So I've been talking with a local RE about doing my FET in a couple months, and she's had some less than positive things to say about my embies for various reasons.  I spoke to Dr. Potter on the phone last night to get his input on this and he disagrees with nearly everything she's saying . . . so I'm confused!   I want to cycle here, but not if it's going to hurt my chances.

My local doctor has cautioned me that my frosties may not do well in the thaw because in her experience the thaw rate with PGD embies is poorer than those that have not been through PGD.  That's concern #1.  Dr. P said they see no difference in thaw rates with PGD versus non-PGD embies, and that my embies look great and should do fine. 

The results of the genetic testing on the tissue from the D&C said there were 7 cells that had 45 chromosomes, and 13 cells that had 26 chromosomes.  My OB, who performed the D&C, told me that the healthy tissue was my tissue, and the unhealthy was the baby's.  Dr. Potter and my local RE disagree with this, and think that the baby had mosaicism (part normal cells and part abnormal cells).  The local RE thinks this mosaicism raises a big reg flag for the remaining frosties - like they're more likely to have issues.  She was looking over the PGD report and commented that we had one trisomy, one undetermined, and 9 healthy XX's.  Of the 9 XX's, 2 did not make it, we transferred 2, and froze 5.  (I say helathy, but we only did 2 probe so we don't know exaclty how healthy they are.)

To me, 1 trisomy, 1 mosaic, and 1 that didn't take doesn't equal all terrible embryos.  Dr. P agreed, and said he thinks I have a baby in the frozen bunch (which I loved hearing! He's so encouraging).

Do I continue to cycle locally since it's so much easier, or do I go to CA to cycle with Dr. P since he has a lot more faith in this cycle?  How important is that really?  The local clinic has much better frozen rates (46% versus 26 or 28% for HRC).  Their embryologist is supposed to be amazing, and their FET protocol looks pretty standard.  I don't like that my local RE is so alarming about all of this, but the clinic is very reputable and has great frozen rates.  I feel like if I can get over her pessimism then it's best to stay local.  Her attitiude can't affect the way the embies thaw or the clinic's standard protocol.  Am I missing anything though?  What do you all think?

I would work with another RE in the practice or atleast do a consult with one. I know your RE and she is just like that. I don't know why you would stay with her if she lacks confidence in you and I would tell her that. I think part of the reason their FET rates are so good is they only freeze blasts and the culture solution. The process is the same no matter where you go. I would get a new doc and stay local. JMO.

wow! That is a lot to think about. I was told that the thaw rates were the same. I had 4 frozen and all 4 thawed out just great! I know this sounds bad but even if you lost one you would still have 4 left.

I'm no expert but isn't it refreshing to know that you already have 2 healthy boys. Wouldn't the odds be in your favor that you have gotten rid of all the unhealthy ones and now only healthy ones are left? I mean, it seems weird to have healthy boys and then all embyros have something wrong with them. 

Do you think your local place is just trying to get you to start a whole new cycle and pay more? I know that sounds awful but just a thought. I was told by the RE that did my fresh cycle that it didn't matter the clinic's rates b/c you have to figure the rates for where they came from. The local clinics frozen rates are probably from mostly people that did their fresh their and then followed with their frozen. Where I did my FET the rates were much higher than were I did my fresh but I was told that wasn't too much of a factor.

I feel like I'm rambling. Good luck on your decision. It looks to be a difficult one. Please keep us updated on what you choose. I hope you get your little one soon!

 My one Pgd frosty implanted and she is 2 month old.  I only had 1 and it thrawed  and my frosty wasn't good quality.  You have many more, I would trust Dr Potter's advice even if you choose to cycle locally.  Good Luck!

I agree with you and Dr. Potter that your frozen embies are not more likely to be sick.  You very likely have some viable ones in there!!

BTW, in my successful cycle (it was fresh), I had 9 embies go to PGD.  We did 2 probe PGD and all were reported flawed except 3.  We transfered 2, and got twins!  I mention this to show that just because some embies in a batch are bad, not all are.  lol

As far as where to cycle, I am torn.  Local is easier, and I agree with a PP that if you want to go that route, you might do well to consult with a different local RE.  I believe you and your doc should be on the same page regarding your chances for your FET.  Who wants a pessimistic RE doing their transfer???  lol

GZ

 I would tend to do it locally.  While it might be a bummer hearing the RE say that she doesn't have confidence in the embies, it won't effect the outcome.  IE she can't wish it not to work.  It sounds like she has a good track record, despite being a Debbie downer.  You just need to prove her wrong .  Good luck, whatever you decide.