Forums  Gender Selection Gender Prediction Gender Disappointment Gender Odds

PGD probe 9 vs. 12

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1-Jun-07 7:58 am

Yesterday I met with my doctor at SIRM to have my mock transfer.  We talked about advantages of the 9 probe PGD versus the 12 probe PGD and I just thought I'd share the info.  He said if a patient is really afraid of transferring two embryos because of the risk of twins he would recommend the 12 probe because it rules out more abnormalities and hence increases the chance of a normal embryo being transferred.  He said if the patient is fine with transferring 2 embryos and possibly getting twins he would recommend just going with the 9 probe.  The 12 probe is usually about $500 more than the 9 probe, and is not any "harder" on the embryo.  DH and I are still contemplating what to do. 

Next week DH and I will be headed to MS for our sort.  Lately I have been thinking that if we get really lucky and have like a 95% sort maybe we don't really need to do PGD.  I decided to ask my doctor is opinion on this as well.  He said he just finished a cycle with two MS patients.  One had a 90% sort and had all female embryos.  The other had a little bit higher sort but had 50/50 male/female embryos. This confirmed for me that I still want to do PGD.  Even if I have a 95% sort there are still many, many, many Y spermies in that vial so I don't think I want to take the risk.

Baby Boy 2002 Baby Boy 2006 #1 IVF/MS/PGD, cycle cancelled #2 IVF/MS/PGD, BFN #3 IVF/MS/PGD, chemical #4 IVF/PGD, BFP, M/C 9w5d Baby Boy 2010 Although it's hard, the time has come to let go of the dream...
 

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1-Jun-07 10:24 am

Thank you for sharing this info but all is good when someone has lot of excellent embryos to work with. The accuracy of PGD of aneuploidy is approx. 90%. This means chances of misdiagnosis is 10%. There is also possibility that testing will not work and will not give result. A mosaicism can also occur ( see HOLA’s case). On top of that, PGD cannot test all types of aneuploidies that’s why prenatal testing (CVS & Amino.) is recommended even after PGD. IMO, if somebody is doing it for gender, only gender panel is sufficient? Did you talk about doing only Gender Panel?

Thanks again….NTJ

IVF/MS/PGD cycles(Fresh & FET) in 2006...All embryos PGD normal,No Implantation! Fresh IVF/PGD cycle in June 2007...All embryos PGD abnormal,No Transfer!

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1-Jun-07 10:26 am
since you are taking out the cell anyway my doc recommends doing the 9 or 12. I am doing 9 probe.

Jodi, Mom to 4 little boys

3/07 MS/IVF-17 fertilized-RE said NO Transfer due to slow embryo growth

6/07 ivf/pgd, NO transfer, normal female arrested!

decided to go low tech....6/08 TBM "opposite" born, my little sweetheart

2010 here we come, what will we do next??

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1-Jun-07 11:00 am

It seems 9 and 12 probe are the standards SIRM offers, is this what you understood to be true Jodi?  Also, since we have had a number of discussions on this board about PGD being hard on the embryos I asked my doctor about this as well.  He said if a good lab does the PGD, it is not hard on the embryo IF it is a good embryo.  There certainly seem to be some conflicting opinions on this though....  My doctor has a good success rate, whether it will be true for me remains to be seen but for now I just have to move forward with things as planned!

Baby Boy 2002 Baby Boy 2006 #1 IVF/MS/PGD, cycle cancelled #2 IVF/MS/PGD, BFN #3 IVF/MS/PGD, chemical #4 IVF/PGD, BFP, M/C 9w5d Baby Boy 2010 Although it's hard, the time has come to let go of the dream...

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1-Jun-07 11:55 am

We're doing this for family balancing purposes so we did the 3 probe - I had 4 embryos - I initially was going to do the 5 probe but b/c we had so few, the embryologist came to us in recovery after ER and we discussed it.  The 5 probe tests for those defects that could sustain a viable pregnancy (downs, trisomy 13 and another - plus gender - X and Y).  The 9 and 12 probes add chromosomes that if abnormal would not implant or miscarry on their own.  The 3 probe tests for downs and gender only.

If you are younger and make a ton of eggs, you are in a different boat than I.  I was worried about an incorrect diagnosis or mosacism (it was pointed out above that we in fact did have a mosaic embryo) and did not want to take the chance of throwing out a perfectly good embryo.  This is all so personal and the analysis is different depending on the circumstances.  I only interviewed SIRM in my area but am not a patient there - I did get the sense that they are fairly formulaic (and they have a lot of success with that!) so if you want to do something outside their standard procedures, I think you'll have to raise the issue (I could be totally wron on that one - no intention to offend).

 Note that only one cell is typically removed so there is no effect at all on the embryo between a 3, 5, 9 or 12 probe - they just test that cell differently.

Good luck!

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1-Jun-07 12:18 pm
this is a great question.

i was told to have a 5 probe. but now i'm wondering if i should have more testing done....they only have to take the 1 cell and do all tests on that, am i correct? or if you want a 9 or 12, does that mean removing more cells from the embryo?  if not, than there shouldnt be any more danger to the embryo regardless of what panel you choose...i guess then there is the concern that there isnt 100% certainty with some of the tests yet.  

also, i am so confused about this mosaicism thing?  could someone explain it a little more?  and is this something that i have to talk to my RE about when the time comes, to make sure that we arent going to throw away an embryo that may be ok?  

ugh, so much to think about, my brain hurts.

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1-Jun-07 12:20 pm

Does anyone know of a good site listing what the different probes test for? Could be a great resource for this board, since the PGD issues, what it does, what it doesn't do, come up again and again.

I'd be curious what a 9 and a 12 test for. Sounds like a lot!

Thanks for sharing stories of how many tests and why. I think that the SET argument could be sound. And it's good to know that even a high MS sort could still result in an embie mix of 50-50!!!!! 

WWP

Baby Boy '04 Baby Boy '07 Baby Boy '09 He's here!

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1-Jun-07 12:24 pm
You're correct--it is just one cell that is removed.  That's why if an embryo goes through a 12 probe PGD and tests as "normal" it is more likely to implant because more abnormalities have been ruled out. 
Baby Boy 2002 Baby Boy 2006 #1 IVF/MS/PGD, cycle cancelled #2 IVF/MS/PGD, BFN #3 IVF/MS/PGD, chemical #4 IVF/PGD, BFP, M/C 9w5d Baby Boy 2010 Although it's hard, the time has come to let go of the dream...

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1-Jun-07 12:26 pm

WWP,

 A few months ago I looked up the 9 and 12 probes on the internet.  The list of abnormalities tested was quite long and included a lot of diseases, etc. that were not at all familiar to me so I think they may be quite rare. 

Baby Boy 2002 Baby Boy 2006 #1 IVF/MS/PGD, cycle cancelled #2 IVF/MS/PGD, BFN #3 IVF/MS/PGD, chemical #4 IVF/PGD, BFP, M/C 9w5d Baby Boy 2010 Although it's hard, the time has come to let go of the dream...

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1-Jun-07 12:33 pm

Still nothing on 12 probe, but here http://findarticles.com/p/articles/mi_m0CYD/is_15_39/ai_n6157627 is a decent listing. The numbers represent the chromosome where they are looking for trisomies and other issues.

"Investigators compared the detection rates of aneuploidy by panels employed by various national laboratories that specialize in preimplantation genetic diagnosis (PGD) using fluorescent in situ hybridization (FISH). These panels scan for abnormalities on the following chromosomes:

* 5-probe blastomere biopsy: X, Y, 13, 18, 21.

* 5-probe polar body biopsy: 13, 16, 18, 21, 22.

* 9-probe polar blastomere (Reprogenetics): X, Y, 13, 15, 16, 17, 18, 21, 22.

* 10-probe blastomere (Alfigen): X, Y, 8, 9, 13, 15, 16, 18, 21, 22.

The 5-probe blastomere biopsy would have detected about a third of abnormalities and conceivably would have prevented fewer than 20% of the miscarriages in the sample. The 5-probe polar body biopsy did "slightly better," said Dr. Lathi.

The 9- and 10-probe panels yielded a far more accurate, and identical, result, each detecting 61 of 79 (77%) abnormalities. Using these panels to conduct PGD on embryos in the sample could have reduced the miscarriage rate by 46%.

Similar results were seen when the investigators applied their results to subpopulations: only those infertile patients undergoing IVF, or only those with a history of at least two previous miscarriages.

An important caveat with PGD is that it is not 100% accurate when conducted on day 3 embryos, the researchers noted. Some early embryos that appear abnormal may correct themselves, and even the 9- or 10-probe panels missed abnormalities on other chromosomes, although improved molecular detection techniques may refine future panels offered by PGD laboratories."

WWP

Baby Boy '04 Baby Boy '07 Baby Boy '09 He's here!

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1-Jun-07 12:36 pm

Hi Hola,

I am totally agreed with you & after a lot of discussions; I am also inclining towards X, Y & Downs. If we will get good number of embryos, maybe then we can add 5 probes panel (X,Y & three major trisomies) .It’s true that 9 & 12 probes add those chromosomes that if abnormal would not implant or miscarry on their own. In PGD you cannot exclude all aneuploidies anyway and adding 9 or 12 panel means you are ready to take 10% chance of misdiagnosis, mosaicism etc.?

Funny thing is that when they talk about PGD is 99.99% accurate …they are talking about only Gender Panel! For Aneuploidy it is only 90% accurate and this is ONLY for 12 chromosomes not all.

Checkout the POLL in IVF connections Board (Poll: Did you m/c with PGD?)

Current Result (81 Voters) showing miscarriage after using PGD (40.74%), still trying to get BFP (29.63%) & BFP after PGD and carried to term (29.63%). I know this is not in some medical journal but really showing some negative side of PGD….the science which is still very new!

At the end, this is very personal decision.

Good Luck!

IVF/MS/PGD cycles(Fresh & FET) in 2006...All embryos PGD normal,No Implantation! Fresh IVF/PGD cycle in June 2007...All embryos PGD abnormal,No Transfer!

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1-Jun-07 12:41 pm

...and a decent PGD explanation of the actual process and what the lab is looking at, although it is geared toward an infertile, 35+ audience.

http://www.socalfertility.com/ivf-pgd.html

About midway down the page, in the middle of a long paragraph:

"Currently, cells are tested with probes that detect twelve of the 23 chromosome pairs: 8, 13, 14, 15, 16, 17, 18, 20, 21, 22, X and Y. This means that a cell from a normal embryo would have 24 spots of light detected when tested."

In fact, this site explained PGD chromosome analysis and looking for sickle-cell, cystic fibrosis, and other genetic disorders better than any other--in lay speak, even. How it's done, why it is so technically difficult, and what it is not at every ART facility.

WWP

Baby Boy '04 Baby Boy '07 Baby Boy '09 He's here!

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1-Jun-07 12:47 pm

"Checkout the POLL in IVF connections Board "

Could you provide a link? And do they describe what type of probe they used? What if it's a lot of 5-probe people that the article I posted above says misses a lot that 9 and 10 probes catch? And how big is the sample of women responding to this poll?

Do what you feel is best, but I wouldn't let $500 be the deciding factor. In for a penny, in for a pound. After spending $10,000, what's another $500 that could help you choose the very best embies with the greatest chance for success (and peace of mind), especially when so many here are only transferring one or two embies at a time?

WWP

Baby Boy '04 Baby Boy '07 Baby Boy '09 He's here!

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1-Jun-07 12:47 pm
may i ask, why does the number of embryos you have to start with make a difference in which panel you choose?  wouldnt you test all of the embryos anyway, especially if you want to know the gender? and since its only 1 cell thats removed, it wouldnt make a difference if you had 5 embryos or 10, it wouldnt have any different affect on the embryos--they would either survive, arrest or be abnormal.  can they detect with complete accuracy the 3 chromosomal defects performed in the 5 probe?

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1-Jun-07 1:41 pm

I think I would boil it down like this. 

1) Advantage of doing MORE probes: Find more chromosomal abnormalities, if they exist.

2) Disadvantage of doing MORE probes: More expensive.  May eliminate embryos which would actually turn out to be normal.

There seems to be a lot of debate in the infertility world now about whether PGD actually has a high false-abnormal rate due to mosaicism.  Mosaicism means that not all cells in the embryo are identical.  This assumption that all cells are identical is the basis of PGD, because only one single cell can be tested.  There is some evidence that some embryos may have both abnormal AND normal cells, and the abnormal cells may just die out and the embryo will continue to develop normally.  So if you do PGD and pick one of those abnormal cells, you may be discarding an embryo that would have been perfectly normal.  Of course there is no way to know this. 


Mom to And Microsort/IUI twins!



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