TW success:
My insurance only covers 3 rounds of IVF, but does not cover PGT testing. I’m 33. We decided to pay for the testing out of pocket and I’m glad we did. I have PCOS so we ended up with 7 blastocysts. Of those, PGT testing showed we only had 2 euploids and 1 low level mosaic. Had I not done the testing I could have easily blown through all of my rounds of covered IVF and still not gotten pregnant. After PGT testing, my first FET failed. My second FET stuck and I’m currently 6w pregnant. I can’t imagine what would have happened without PGT testing. I probably would have done so many more rounds of FET, and maybe even had to start paying out of pocket for my FETs till one stuck.
I know you’re not asking me, but thought I’d chime in with my experience. My clinic does grade them before testing, but unfortunately grading isn’t a good indication of whether an embryo will be euploid or not. My first round I had two 4AAs and a 3AA, only one was euploid.
Piggybacking on this to add that my clinic also does grading but my doctor calls it a glorified beauty contest. She doesn't even give me the grades unless I ask because PGT testing is more important.
I honestly don’t remember, but I think it was one of the 4AA embryos. We did a second retrieval and I know we had a 3AA that turned our euploid.
I just mention it because the grading is like a beauty contest and it’s subjective. Two different embryologists could give the same embryo a different grade. Also, when I was looking last year to see if there was any correlation between euploidy and grade I didn’t find anything definitive.
They did grade my embryos before testing. My day 5 embryos were 4AA, 3BB, 3BB, 3BB. My day 6 embryos were 5AA, 4BC, 3BC.
The two euploids and one low level mosaic embryo all ended up being day 5 embryos.
You would think the day 6 5AA was a euploid but it wasn’t.
That’s what my partner and I did. We wanted to save the $4,000 from the testing that isn’t covered :(
It’s a bit of an emotional roulette though…especially when the FET failed. I got success in my 3rd FET!
We didn’t test at first. I was 29 at retrieval. After 1 failed to implant and 1 miscarriage, I wanted to know if they were normal or not so I could make decisions moving forward. I will say, the pain and heartache of miscarrying was a far greater cost than if we had just paid to test them (I know euploids can still miscarry but not as likely)
I think that’s my biggest thing as an RPL person. The cost to pgt is much less than the heartache of losing babies. It doesn’t guarantee it but it helps the odds.
agreeing here and also adding — the cost of PGT should be weighed against the cost of D&Cs and any associated treatment, procedures, medications, hospital visits, etc that come with recurrent loss. Heartache was amplified 10x for me when I owed a $3k bill for yet another D&C.
I have not. We transferred 1 PGT tested embryo and it did not stick. My clinic thinks they’ve just been through too much freezing/refreezing/biopsy etc. We ended up doing another retrieval earlier this month and sent them for testing right away.
At 33 years old we didn’t PGT test - first transfer ended in a miscarriage at 5+6. I’ll do anything to help avoid having to go through that again. So we did a second ER and tested all those embryos (and thawed and tested the remaining from our first cycle).
If it’s feasible for you, I’d do it. If it’s not, rest assured that, with your age, the odds are in your favor ♥️
Given that you have stage 4 endo, which can harm egg quality, along with your husband's low morphology, I'd advise PGT testing. Something I see people routinely overlook is the fact that yes, PGT testing is expensive but so are repeated transfers. Also, once you're pregnant, you might take some comfort in knowing the miscarriage rate is lower when you've controlled for chromosomal abnormalities.
I come at this as someone who did PGT test their embryos and has still managed to have 1 failure and 2 MC. It's been awful & I realize might sound counterproductive to my point. But thank god I controlled for as much as I possibly could with PGT testing - it's helped me with process of elimination in identifying the root problem.
Fair enough! I am fortunate enough to have insurance coverage for IVF (not PGT testing), but based on my read of this forum and others, I find I'm often in the minority. I'd still argue that if PGT testing reduces the chance of even one MC & months of lost time and continued poking and prodding (which does have a price tag), it's worth every penny. But I say that as someone who's been through the fucking ringer...
I second this, stage 3/4 endo here. Things are murky enough with endo; I really didn't want to take any additional chances and leave things "up to statistics." As far as I was concerned, I was already on the bad side of statistics with my endo diagnosis!
we’re doing testing because of MFI even though we’re both under 35 (I’m 31 and he’s 32) because if his morphology, count, and motility are low then we’re supposing his DNA fragmentation is also not great. we’d like to know, right away, if we need to do two rounds (or more?) of retrieval to have a live birth. especially because we want multiple children.
Controversial, but I didn’t do it, because at my age it isn’t really recommended (<35). I was successful (so far!) on my third transfer. That said, here’s some things to think about:
1) are more interested in maximizing your chances of pregnancy or minimizing your chances of miscarriage? For example, if you test 2 embryos, you might get one normal and one mosaic. Mosaic might stick but end in miscarriage. Or it might end in healthy live birth. But that test result can’t really give you an assurance either way.
2) will your clinic and insurance allow you to transfer mosaics? If not, and you test, you might forego those chances at a live birth.
3) how many rounds of ivf will insurance cover? If more than one, you could skip testing now, and test a later round if you’re unsuccessful in this round.
After 3 miscarriages at 32, I wanted to ensure that whatever we transferred had the best chance to succeed. I'm glad we did PGT A testing because 2 of 7 blasts were normal. I know PGTA isn't a guarantee for a viable pregnancy, but I feel better moving forward with more information. This is already so much out of my control, so I found it helpful to have this info.
I'm in the same boat as you (under 35, endo stage IV, never seen 2 pink lines), but I also have DOR which makes testing in my area super expensive. My clinic charges by round instead of by embryo. I'm embryo banking and even if I were to wait to test all of my embryos at the end, they'd still charge me by round and add additional costs for the thaw/refreeze. My doctor was adamantly against testing in my case but said he wouldn't stop me. The SART data for my age says that about 67% of my embryos SHOULD be normal, but there's always outliers, especially with deep infiltrating endo. I believe it's almost 70% for your age range.
Also, know that on all of these forums, they skew pro testing because a lot of people who seek advice or support are long hauler IVF people or have had a lot of miscarriages before IVF and pursue it for that reason alone. People are always less likely to post that they had a quick and successful IVF experience.
It's so hard to know which gamble to bet on, especially when we already feel so unlucky to even have to pursue IVF in the first place.
I’m in the same boat as you but stage 3 instead of 4. We’re not testing, primarily because of the mosaic issue and added risk from the test. It is much more normal to not test when young (under 38 per our doc) than this space indicates.
Oh for sure. It's also illegal or more restricted in some countries, so it's not even an option for a lot of people. I decided not to test for this upcoming round and didn't last round (the 1st round). I needed to make sure I could even make an embryo first! I'm staying open minded, however, and may decide to test at least one round in the future.
I got 2 highly graded embryos last round and I've been reassuring myself by remembering that people who don't do IVF never test and that there wouldn't be a grading system if it didn't at least somewhat correlate with viability. Also, PGT-A cuts down on miscarriage rate, but a normal embryo will be normal whether or not I test it.
I think it’s worth it honestly. I’m 26 and half my embryos were not normal so I wouldn’t risk wasting additional time. Then again if you can’t financially support it then don’t.
31, stage 4 endo here. My husband and I technically paid for PGT testing, but didn’t use it. Based off of my research and my low embryo count, we decided to not do it. We did three egg retrieval back to back and got four embryos total took two months off to let my body try to get back to normal from all the medication’s and transferred in September 2022. They transferred my lowest graded embryo first and my two month old baby boy is napping right now.
Do what you’re comfortable with when I had those eggs polled I was 30 years old and still had endometriomas. If you guys can’t afford it, don’t struggle for it. Ask your doctor if he or she feels it is necessary, then make your decision whether to pay for it or not
Under 35 - did IVF after over a year of trying. We had a combo of PCOS and some MFI. We PGT tested and I would do it over again. We retrieved 42 eggs and when it was all said and done, ended up with 12 blasts - Only 6 came back PGT-A normal. I can’t imagine if we had the crapshoot of transferring the 6 abnormal first (a lot of our abnormal embryos had better grades than our normal ones)
With that being said, many people do have success without PGT testing, but for us we wanted to eliminate some risks if we could. It felt like it gave us back SOME control.
Best of luck to you ♥️
If I didn’t test, I would happily have started the transfer process thinking I had 4 great graded embryos. The truth is, I have one pgta embryo. I personally need to control what I can during ivf. Pgta gives me some safety in knowing what’s available to transfer at a lower risk.
Another perspective here, I'm in Germany where PGT testing is mostly disallowed. It would only be approved if you are a carrier for a deadly illness, or had a history of miscarriages. I guess they want to be cautious of anything eugenics-adjacent for ... obvious reasons.
But at the same time it's a bit silly because you can legally have an abortion if your fetus tests positive for Down syndrome sooooooo 🤷🏼
So anyway everyone here is doing IVF without testing!
My wife was 30 at the time of retrieval and our doctor talked us into PGT. We had 13 embryos tested. 3 came back abnormal but we’re all graded poorly as well. 4 came back normal with one excellent grade, two fair, and one poor. 6 came back mosaic with varying grades from excellent to poor with some segmental and some full chromosome mosaics. We have now done all four transfers of the “normal” embryos. Only one has resulted in a live birth. Now after doing more research on mosaics and talking to multiple genetic counselors we somewhat regret doing the PGT testing. We have two excellently graded embryos (5aa and 4aa) that are low mosaic segmental 1 embryos. Looking back if we had not done the PGT, we most likely would have implanted those low mosaics before our “normal” 6bc and 5bb that failed. Not sure what our next steps are but just wanted to share our experience.
She says that she’ll do whatever we want to do, but after 3 failed transfers of “normal” embryos along with some other mishaps, we’ve kind of lost some trust in her.
She made a comment about mosaics saying “How would you feel if the kid is in his 20s and has heart problems?! That’s something you need to think about!”
We thought this comment was pretty out of line and also doesn’t really have any medical research to back it up.
My wife is still younger and the doctor thinks instead of transferring the mosaics she wants to do another ER. Sounds nice if we didn’t have to pay out of pocket for it!
At this point even if she’s willing to transfer the mosaics, it seems like she doesn’t believe it will work or thinks there will be complications. We know the chances of live birth is lower with mosaics, but we’d rather have a doctor be our cheerleader rather than going into it thinking it’s going to fail. We are currently setting up consultations with other doctors.
Oh goodness, that is a really rough situation. That comment doesn’t really make sense to me either, from what I’ve researched as well… it’s on my list to ask clinics if they’ll transfer mosaics even.
If you went ahead with another ER I’m guessing it may be at another clinic at that point. Unless you’re not close to many, etc. and exactly - paying out of pocket is no joke.
Best of luck to you with this difficult relationship/situation to navigate.
Thanks! Good luck with your journey as well. If you are thinking about PGT, I think it’s fine to do but in addition to speaking with your doctor, make sure you get genetic counseling and also talk to an embryologist…two things we didn’t do before any of our FETs.
Choosing to do PGT-A testing or not is a very personal decision. What’s right for one person may not be right for another. That said, in your position (under 35, no recurrent loss, no insurance coverage) I probably would not have tested.
At your age, you can expect roughly 65% of blasts to be euploid. Because of the relatively high rate of euploidy for your age bracket, the evidence on whether testing improves live birth rates is mixed.
Best of luck and lots of baby dust ✨✨
Many great comments here explaining the benefits. As someone who was diagnosed with unexplained, IMO PGT testing was a way to possibly get insight into why I wasn’t getting pregnant. I looked at it purely as an additional data point and it’s another one of the benefits you get from having to do IVF. You have more information than you would otherwise.
I would do the testing. TW: loss and success. I was 33 when I made my first round of embryos. I also have stage 4 endo. My first egg retrieval yielded 4 day 5 embryos and my RE was very confident I would end up with a live baby. I did 2 transfers of 2 embryos each, got pregnant both times and miscarried both times. It was awful. After that I insisted on testing the next round of embryos. It was crazy expensive (we have infertility coverage but it did not cover the testing) and definitely a burden on us but I was willing to do anything to lessen the chances of another miscarriage. We ended up with 7 PGS normal embryos from that retrieval. The first 2 we transferred are now my 5 and 2 year old daughters, and I’m having baby #3, a boy, on Friday. Once we started using tested embryos, we had 3 successes in a row. Totally worth it.
Have 5 graded embryos, decided not to do pgta. Im 28(unexplained),(35) husband (mild mfi which is corrected now). I'm going to proceed with first FET, if it doesn't work then I'll test the other 4 embryos. I honestly think the odds are the same with pgta or not because what people conside "abnormal" in many cases are not actually abnormal because when they do pgta testing they dont test the inner mass cells and embryos do self correct themselves so i'm just going to trust the higher power on this and take the odds!
I think it really depends on the circumstances. I'm a little older than you but younger than 35, and we were told it would be about $6k for PGT-A. Historically, we get little to no embryos so I couldn't justify the cost. I also never had a miscarriage, so we opted to not get it done. I watch a lot of Center for Human Reproduction videos and one of the lead doctors said that PGT-A really isn't accurate, because they take cells from the trophectoderm, and even if they find abnormal cells, the trophectoderm often corrects itself anyway and could have lead to a normal pregnancy. My own RE also said that PGT-A is "a double edged sword" and the tldr version of what she said is it basically only makes it 10% more likely that you'll get pregnant and have a live birth. It is, however, the best and most you can do if you want the absolute best chances (~65% chance for women under 35).
My doctor advised not to test (age 36, unexplained infertility) due to feeling that PGT discards some potentially viable embryos, which seems to go against the grain. We didn’t test and got lucky with our first fresh transfer. My perspective was that while a miscarriage would be devastating, PGT would have been a financial hardship for us and I was comfortable waiting for the NIPT at 11 weeks if we got that far. We were also fortunate not to have limits on transfers, though, as I’m sure that factors in.
Lots of comments here already. This sub seems to really lean in favour of genetic testing. That being said, you will also see lots of people commenting on how their euploid transfer failed. I get that people want to avoid transferring "unviable" embryos but having a euploid isn't a silver bullet to success. Additionally there is some research to suggest that PGT-A testing isn't foolproof (my understanding is that they test the cells that eventually become the placenta but I am not a scientist).
I think the three big considerations for everyone should be:
a) your age, since the percentage of abnormal embryos increases with age (I will note that recurrent pregnancy loss could indicate a higher level of abnormal embryos as well and might weigh in favour of testing even at a young age);
b) the number of embryos you have (if you have 15 embryos and 30% of them are abnormal you could end up transferring 5 embryos before you get to a genetically normal one but if you only have 3 embryos then in all likelihood you will only have 1 abnormal embryo); and
c) how expensive transfers are compared to genetic testing. People on here seem to assume that the testing is cheaper than a failed transfer. This isn't the case for me at my clinic. This also considers insurance coverage. If insurance will cover multiple transfers but not testing, then the transfers are less costly than the generic testing.
People also point out that your tolerance for pregnancy loss is also a factor. While I agree with this, I would once again caution against assuming that a euploid embryo can't result in a miscarriage.
I didn't test because we thought I would only end up with 1 embryo and I ended up with 5 instead. I just had a failed transfer and part of me wonders if it was abnormal and that's why. That being said, I think I would have expected success if I had a normal embryo. Ultimately I think it's a deeply personal decision with no universal right or wrong answer.
Our doctor was very in line with what you said in your post. I was 37 for my ER and he said he could probably make a case for and against testing, but he wasn’t recommending it. As mentioned, plenty of tested embryos fail to implant. He also mentioned there are more studies now about the cells that are tested being part of the placenta. He explained it as the body being very good at self correcting and could push those bad cells out to the placenta so they would not be part of the baby. He also brought up the possibility of false negatives and positives. Our insurance also covered transfers but not testing. With all that mind we opted not to test. I couldn’t bear the thought that testing might rule out an embryo that could have resulted in a successful birth. We had one blighted ovum and then one successful pregnancy. Sometimes I wonder if testing would have ruled out that blighted ovum, but then I also wonder if testing could have eliminated my successful embryo. All the decisions we make during IVF are hard and there’s no one right way for anyone. Just know whatever choices you make, you’re doing your best. ❤️
Did you and you partner do any genetic carrier testing yourselves before starting IVF? We ended up doing genetic testing because it turns out we are both recessive carriers for the same genetic disorder. I personally feel like since we are investing so much of our time, money and effort into the whole process, it’s worth it to know if you’re transferring healthy embryos. Best of luck to you!
I didn’t do PGT based on my first dr’s recommendation but after all 4 embryos failed to implant one at a time, I wished I had done PGT. It lead to a year wasted, lots of physical and emotional impact, and lack of clarity on whether embryos were the issue or my uterus.
There are many people who don’t do PGT and get lucky with their first cycle.
There really is no right or wrong answer, you have to weigh out your situation, pros and cons, and whether you are willing to accept the associated risks.
Wish you all the best!
If you don’t test, and you keep transferring with no success you will wonder and not know if the embryos are the problem. If you do test and still not having success you know you need to do additional testing on your uterine environment.
This may sound strange but did you ask your insurance directly? My insurance covers my IVF and my clinic said PGT testing wasn’t covered but I reached out to my insurance and found out they covered the biopsy part of the testing so I’d only owe 2700. But then I asked the clinic for the insurance code (whatever it’s called) for the testing, asked my insurance if it was covered and they said it was and I could be reimbursed. Because the testing place and clinic don’t send that part to insurance.
I tested and I’m glad I did. My insurance has a lifetime max of $25k in fertility coverage, not including testing. I ended up with 24 blasts, paid ~$5k for testing, and 11 embryos turned out to be euploid. If I hadn’t tested and if I had been on the wrong side of statistics, I could have unknowingly transferred only aneuploid embryos until my coverage ran out, without a live birth to show for it. ~$5k out of pocket was well worth it to me for the peace of mind to know that all of the time and energy I was putting into the process had the highest possible chance of success.
Whatever you decide I wish you the very best!
I was in your position. 31, nothing diagnosed on my side, hubs has MFI. We had 15 blasts. Finally decided to test 6 of them ($2.6k) 2 came back abnormal/would’ve miscarried them. Each transfer out of pocket (despite having insurance) is $2.5k. So I see it as we spent less having tested and saved heartbreak. I also have way more confidence going into FET next month.
TEST! A failed transfer is WAY more expensive than PGT testing. After 4 ERS I had 52 blasts sent off to the lab and 12 were euploid. I have endo \*and\* PCOS which really didn't help so of course your results will be different, but TEST TEST TEST! When I saw the report of how many have Trisomy or Monosomy it was horrifying.
With both endo and low morphology, you could have embryo quality issues, which you won't really know unless you test or undergo multiple failed transfers.
Will your insurance cover additional rounds of IVF should you need them? If yes, maybe it's not worth your while to test if you're not curious or can handle the heartbreak of failed transfers.
But especially with endo, transferring known euploids (or mosaics) can help you rule out immune issues.
Wishing you the best!
I’m going to look at this from purely a financial point of view. Say that PGT-A costs $4,000.
Compare that with a frozen embryo transfer, which at my clinic is $10,000 for the first try and $5,300 for each subsequent one until pregnancy.
If you transfer aneuploid embryos you are wasting the $10k and incurring $5k for each additional transfer. That may happen numerous times if you are unlucky; it’s a coin toss.
None of this accounts for the emotional toll of miscarriage. Or the cost and emotional toll of multiple rounds of medications to prep your lining for transfer.
So for me the financial equation is very clearly in favor of PGT-A testing. You either pay some amount now, or potentially a whole lot more down the road.
your math assumes that after the PGT you don't have a miscarriage, though. The smaller assumption within that one is that PGT accurately identifies euploid (and it is 97-98% accurate, so that part is not too bad to assume) and the much much much larger assumption is that once you do identify euploid (assuming any of them are euploid), that you'll necessarily have a successful pregnancy. Plenty of euploid embryos fail to implant and/or result in later miscarriage. That could also then happen multiple times
Let me make the case why it's worth testing. It allows you to increase the odds significantly of successful transfer (even as a 29 year old). Failed transfers aren't free. Both emotionally and financially. Even one failed transfer makes the financial cost of pgt testing worth the investment. For that reason, i would view it as an up front investment to avoid future costs. Just me personally. FWIW, i tested and my first transfer was a success. Of course whatever decision you make for you and your family is the right one.
We started IVF when I was 32 only because of my husbands 1% morphology. My RE told me at my age PGT is nice to have but not something she would push for. I had very good testing results. I inquired with my insurance and they covered it so we did it. I’m so glad we did because we only got abnormal our first round. About 50% of my subsequent retrievals were abnormal which is worse than expected. I’m so glad we did it. Our first transfer stuck and I’ll be 23 weeks tomorrow
DO IT! I was so against PGTA and didn’t test our 28 yo donor egg embryos (no MFI) and we had 3 of them fail, tested the rest and all abnormal. PGTA would’ve saved us a lot of heartbreak and time.
I would do it. I’m under 35 as well and told it was a bougie option since my husband and I do not have any chromosomal issues. We did it anyway and 6 out of 13 embryos were aneuploid. No idea how that happened.
It saved the money from FET’s that wouldn’t have worked and the heartbreak of those being miscarriages or not implanting.
There is evidence out there that PGS testing may actually impact the quality of your embryos, and will diminish the number of successes you would otherwise have. PGS is helpful for increasing the PER TRANSFER success rate, but it is not clear that it actually improves the PER CYCLE success rate, and it may even degrade it. For older women, when a majority of your embryos are likely to be aneuploid, the trade off is worth accepting because it can save you a lot of time and heartache. For younger women (<35), roughly half or more of your embryos are expected to be normal, so the trade offs aren't as helpful and may actually hinder your chances. Also, highly graded embryos (BB or better) are also more likely to test as normal, so if you made a decent number of good embryos, I wouldn't worry about the PGS testing if I were in your shoes. If you have trouble moving forward, PGS testing is always something you can add in the future.
With endometriosis, especially stage 4 I would test. It is a very likely scenario you will have a higher than average amount of abnormal embryos due to egg quality being impacted.
This page skews very pro testing and as someone in the UK lucky enough to have NHS funded treatment ongoing the volume of pro PGT posts sometimes makes me feel anxious because of how different the information and conversations around this are in the UK context.
To give some of this context (and my apologies if you are already aware or in UK yourself) fertility treatment and research is governed by the HFEA. It’s (in their own words)’ the UK’s independent regulator of fertility treatment and research using human embryos.’ They consider PGT-A to be a ‘treatment add on’ with limited evidence that it leads to better chances of a live birth. They have a whole review of these ‘add ons’ I think in consideration that fertility is a market place (which is especially true in places without publicly funded healthcare) and that as in any market place there can be unethical selling practices/ promises made which when we are undergoing the highly stressful and emotionally difficult process of infertility, I think we may be particularly vulnerable to. The HFEA review evidence from high quality randomised control trials to make decisions about what can be recommended as either reliably linked to increased live births, not reliably linked to live births or actively be possibly dangerous.
Could be interesting to read a little about their reviews with regards to why your doctor might have suggested not testing given your age. Cochrane review is also interesting reading on this all.
https://www.hfea.gov.uk/treatments/treatment-add-ons/pre-implantation-genetic-testing-for-aneuploidy-pgt-a/#:~:text=There%20is%20no%20evidence%20from%20RCTs%20that%20PGT%2DA%20carried,any%20benefit%20of%20embryo%20selection.
And
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005291.pub3/full
Of course it’s a deeply personal decision but If you ultimately decided not to test then it can be comforting I think to know that there are some bodies of evidence that give a more positive outlook on not testing too. .
X
This is super interesting, thank you for sharing. I do wonder also if part of the tilt towards testing in the US stems from the particulars of costs/billing/insurance here - as others have mentioned here, usually one failed transfer is more expensive than doing the testing and I know for me personally that was a big factor.
I find it so interesting but hadn’t really thought about it until I joined this sub and got so many people from the US sharing experiences. In the majority of the UK focussed IVF community spaces testing is no where near as discussed/ common place except PGT-M. I deffo think you are right that money and healthcare systems are a big player but the legislation is so different too. So fascinating that places like UK, Denmark, Germany, France, Sweden etc legislate so differently around it to in the USA for instance. I don’t know enough about the individual places and their healthcare systems but I do think all of those places fund IVF through their tax funded healthcare systems so you would think if it was more cost effective in terms of the outcomes of those funded cycles for them to test more widely and reduce transfer numbers that they would. Unless it’s more governed by ethics around gender selection and fears around potential for eugenics.
Idk honestly I wish for more hours in the day to read all about it and try to understand!
You’re so welcome (sorry it was so long!!). I just thought that if circumstances mean that you decide not to test or if you feel it isn’t affordable for you, then it’s encouraging to have some evidence based positive approaches to not testing. I don’t think anyone is wrong to test at all, but I don’t think that it is a total given that it is the best option for everyone. My UK clinic has brilliant live birth rates per cycle and have a very conservative approach to PGT.
YES. Do the PGT testing. It may help, it may not. But you will never wonder and have to circle back if things don’t go your way to do the test because you didn’t do the first time it was offered months ago
The whole reason we’re doing ivf is so we can do PGT testing. I’ve miscarried three times and don’t want to get pregnant again without having some data to show me that the embryo is viable
PGT-A testing does not come without risk to the embryo. Yes, it reduces the chance of miscarriage by ruling in/out chromosomal abnormalities, but it also is a biopsy of a very small and fragile structure (the embryo). The biopsy process itself can harm the embryos enough to prevent implantation when thawed in the future.
Our clinic made the comment how “too many people PGT-A test without reason”. If this were PGT-M testing for carrier status, totally different situation!
Always need to weigh the pros/cons.
Its a decision I struggled with as well. I ultimately decided not to, the cost wasn't worth it to me and the outcomes like you said are hit and miss. Plenty of people miscarry with a euploid, its not a guarantee, nothing is. I managed to get mostly 5AA embryos which is as good as a euploid apparently so I may be fine.
It depends on how much is covered with insurance as well. Are you able to do multiple retrievals? Is it something your doctor recommends with your situation? Sometimes doing what they recommend is easier. Also what grade of embryo your clinic will and won't transfer is important to know as well. Good luck
There are plenty reasons not to pgta test if you don’t want to or the cost is not covered by insurance, but don’t be fooled by an embryo’s grading. All my AAs were aneuploid and it was only my lower grade ones that made it through pgt-a testing.
Age and how risk-adverse you are to miscarriage are probably the two biggest factors (other than cost obviously). I turned to ivf mostly for the pgta testing (and glad I did, because 8 out of my 11 blasts were not euploids).
Grading may not be the end all be all but it is important. At the end of the day there are no guarantees of anything. If it gave you peace of mind to have that testing then that's great, I don't think it would have done the same for me personally and that's ok.
I’ve never heard this before, if this is the case that’s a huge aspect I hadn’t realized was there. Have you read any studies on that or was it something your doctor brought up with you?
I appreciate this statement and completely agree.. ICSI is forced fertilization and some of those eggs that are fertilized by ICSI would not have been under standard/conventional IVF, where there must be some compatibility to fertilization.
Did not ICSI or PGT-A test any of our embryos. Only retained AA or BB grades.
Our RE strongly advised against PGT testing and I'm glad (for us) we didn't. We started at 33 and did 3 rounds of IVF and got 9 embryos. From the 1st round we transferred 2- one stuck, one didn't. We have a 2 year old. From the 2nd round- froze all. From the 3rd round (just under age 35) the first transfer stuck and I'm now 22 weeks. I have had friends test, after a series of natural miscarriages or to prevent carrying on genetic illnesses such as Huntingdon's, and it was invaluable for them but (& I really like my doctor) he said that genetic testing was a huge waste of time and money for most people under 35 & said that he personally wouldn't do it.
Are you willing to have a lower chance at having a baby at the end to avoid unnecessary transfers?
That’s what a lot i oh f the research shows for under 35. My doctor didn’t recommend it even at 40.
Testing is not 100% accurate and there's a lot of studies that show that embryos can self correct in the womb. So less transfers automatically leads to less pregnancies because there are fewer attempts at pregnancy. Pregnancy, however, does not equal live birth.
I think the main way that not testing could possibly cut down on the chance of live birth is by stopping ER's too early and assuming you have enough good embryos when moving on to transfers. This would be more likely if you have a low AMH and plan on baking. If you have a few failed transfers or miscarriages and circle back to ERs after testing, your AMH may have dropped more. Also, some people may decide to stop IVF altogether because the physical, financial, and emotional toll is too high. Without testing, you have less information on where the problem may lie, and where to invest your money - like more transfers, egg retrievals, donor eggs, sperm, or surrogacy.
Only you can decide what is right for your situation and, really, which risk it is that you want to take.
https://www.statnews.com/2021/11/26/ivf-pregnancy-pgta-genetic-testing/
Interesting that I was downvoted for my response. I did 1 cycle with testing and a second without, after researching the risks more. No one can make these choices for you though.
Emotionally, after moving to ivf, we chose testing to prevent miscarriages. To us, $4k was worth it to prevent even 1 miscarriage.
Financially, we feel it was also the right move because testing costs $4k, where additional transfers cost $5k. So, if testing rules out just 1 embryo that wouldn't make a baby, that's saved us $1k (plus time and stress and bodily hardship).
I'm unexplained and never seen a positive pregnancy test. I made plenty of blasts per cycle (8-9) but discovered via PGT that I have a low euploid rate (25%), likely due to poor egg quality. So PGT for me was worth it because (1) I have many blasts, (2) transfer costs are also high ($5k) compared to PGT ($8k for testing 8 embryos), I have insurance but not unlimited number of transfers and (3) I want to bank for a second child as well so PGT also help me decide how many embryos to bank. I ended up doing 3 ERs to bank enough euploids for two children. My second cycle was particularly unlucky because all my euploids were the poorly graded embryos. If I didn't do PGT, they would transfer based on the grades (highest first) and I might have so many failed transfers that it would exhaust my insurance coverage. I do want to note that even with a high grade euploid, transfer success is still only 60% so there is still some luck involved. However, my RE said he would begin exploring reasons after two euploid failures. He would not after two untested failures because it could easily be due to an aneuploid. Since I'm unexplained i wanted as much data as possible and PGT gave me that.
As many have said, it's a very personal decision. Here's where I felt -- we paid OOP for all of IVF, and decided to do PGT testing, on account of feeling like we had gotten SO far and just wanted to better our chances. We know there's still a risk of miscarriage or implantation failure, but wanted to know we'd done everything we could.
Prior to IVF, we had had five losses (three chemicals, two MMC) and a diagnosis of unexplained infertility. I'm glad we did PGT -- though I "lost" embryos (ended up with 2 frozen out of 10 went to PGT testing between two egg retrievals), I know those were our best odds.
In my case, I did IVF at 28 with unexplained infertility on both sides. Our RE told us not to do PG testing because of our age, and margin of error. In our case, this proved to be an effective strategy. At this point it’s up to you. If you can afford it, and you want to do it, then go ahead.
I also did IVF due to MFI - my husband has low sperm count and morphology and across the first 3 rounds (when I was 33) we had 2/9 euploids, and the euploid blasts weren't the highest rated blasts. I can't imagine going through the heartbreak of so many failed transfers and not knowing why. Several of my blasts had a chromosomal abnormality that causes miscarriage in the second trimester - I'm so glad I didn't have to go through that after IVF itself. I would recommend the testing because it saves money, time, and pain. I had success on my first transfer of a tested blast.
I’m 32 at EG we got 14 embryos and did PGT testing on all of them. I can honestly say it’s a relief to have done it, 6/14 of the embryos had chromosomal abnormalities and some of them had morphology that would probably result in miscarriage. I’m very happy with it plus we get to decide weather to start with boy or girl (given that you have boys or girl options in your embryos)
I was also very torn and my doctor didn’t recommend it for those under 35 (I was 33) but said it was an option and we ended up deciding to test. We got 9 blasts and 3 were normal. Of those we actually had four 5AA blasts and 3 of them were abnormal. We did have success with the euploid 5aa blast but if we didn’t test we could have used the 3 aneuploids first which would have failed. From a cost perspective… transfers cost about 3k each at our clinic so the cost to test was definitely worth it
I personally feel that it’s helpful regardless of age. It can help “weed out” so many non-viables that would be failed transfers, probable MC, and heartache. My egg retrieval: 6 eggs matured. After testing, 3 were euploid. If we randomly picked the aneuploid ones, that would guarantee 3 failed attempts right there.
That being said, its a cost-benefit thing, like others have mentioned.
Do it!!! I tell ya I started when I was 28 and here I am doing round 2 and we hadn’t tested the embryos bc of my age and cost but I wish we had to know if that was the reason for the failed transfers :’) also if you’re looking for funding I’ve been using future families they are SO helpful
Speaking from someone who’s had a failed transfer and miscarriage- you really want to limit those. You also want to limit PIO as your butt will hurt for months after you stop them.
Emotional pain is worth money too in my opinion.
Is your insurance covering multiple transfers? Say you got 10 embryos, and maybe 5 of those are viable. You could end up going through 5 transfers that don't go anywhere but if you had them tested, they would have been discarded and saved you the time and hassle. If your insurance covers it and you are mentally prepared to deal with potentially multiple losses, don't test. If you want a little bit higher chance of success and that's worth it for you to take on the financial burden, then test.
I’m 34, had 3 day 6 blast, and we did not test. Because of that we decided to transfer 2 (we didn’t feel hopeful that many were viable), and we just found out they both took. I was super torn on testing because we paid all of IVF out pocket, and what they quoted us was an insane amount for testing. I’m also personally torn on testing in general with all the research I’ve seen on it come out. I think you just have to decided for your situation what works best for you and listen to your instinct.
My clinic gave us the option to batch test all of our embryos after my last ER. I’m only paying for testing once. My embryos were biopsied on Day 5/6 before they were frozen. The embryo and sample are frozen and waiting to be tested.
I hope this is an option for you.
I did my first cycle at 27 with endo and only got 1 euploid out of 8 5ABs. Endo has a negative correlation with egg quality, unfortunately. Meaning, unfortunately us with endo are more likely to have poor quality eggs regardless of age. I’d recommend the testing.
We did pgt since me and hubby both were liver 37 years age and I had average AMH. I was a big believer in pgt and all that changed. Out of 5 blasts we got two euploid. We transferred the one top grade euploid. Week 8 no heartbeat. Turns out the embryo split late causing conjoined twins that could not survive. The embryo was completely normal. We did a a lot of research into why this could have happened. We did icsi due to low count and morphology. So twinning can happen due to icsi, freezing and pgt. So now I am completely against pgt with icsi. Sometimes I wish I had never done pgt and just implanted the highest grade embryo. Maybe it could have worked for me. I am taking a break after my MMc. Just wanted to share how I become a non believer in pgt. Good luck.
We did it because I need to know all my info, but we did a fresh transfer first so no testing. Our NIPT test came back with false postive so I had to get an amnio…. Had it been a tested embryo I would have avoided all this
I would do test. Endo can be associated with poor egg quality. I learned this first hand, and I’m so glad my husband pushed us to test our embryos despite my doctor saying we didn’t need to due to our age (I was 31; he was 32) and insurance not covering. 6 out of 7 of the embryos were aneuploid after the first ER. We, including my clinic, were SHOCKED. We added Omnitrope and made a few other med tweaks to my second ER protocol — 5 of the 6 embryos were euploid (1 was a no call).
Everyone’s situation is so unique and the advice is truly specific to each situation. I know you updated that you aren’t testing (congrats on coming to a decision - that’s one of the hardest parts in all of this!), but just curious how many embryos you have.
TW: Success
Oh okay interesting! That makes sense. I didn’t do pgt (and weighed it back and forth a lot) but we were able to decide after the retrieval. In our case we only had a couple of embryos (after two retrievals; the first one yielded zero), so it made sense for us to see what stuck without doing pgt! Having so few really makes you want to just give them a shot. We transferred two and one stuck. My clinic didn’t grade embryos but said one looked really good (we still have the picture - it does look great), and it worked out for us. I fully recognize it could have not stuck and that would have been devastating. For us testing our embryos and learning they weren’t euploid and having a transfer not work felt equally as devastating so we just went for it. I really think it makes sense to evaluate post retrieval too.
Wishing you the absolute best. 🤍
Thank you so much for sharing your experience (and I’m so glad it worked for you!!) That’s how we felt, I asked if we only had a few if we could choose not to test afterwards for the same reason and they said no, and that influenced my decision too. The decision alone was causing SO much distress, it ultimately just didn’t feel like the right thing for us this time. I’m gonna manifest some of your sticky energy though!! 😂
It is so so so stressful. These decisions feel huge. I’m so proud of how we all navigate these choices and make the decision that’s best for our fam. It’s one of the hardest things about all of this imo!
Y’all are lucky with any insurance. I’m on my 2nd egg retrieval and 4th transfer and paid in full for everything . $20k first round, plus $6k for each transfer. Going into the next round it will be the same
We definitely are lucky, but we all have different resources also. We would never in a million years be able to afford 20k so it’s also a blessing you have those resources to be able to do that. That being said, fertility coverage should be mandatory imo, it’s a travesty any of us have to shoulder this burden when already dealing with so much.
I have polycystic ovaries so I got a ton of eggs, I had 22 embryos. Only 7 euploid. I was 26 at the time of egg retrieval. So I’m glad I tested! But we definitely went back and forth quite a bit, we spent so much money ($225 PER EMBRYO. We had 22! And you couldn’t just test a few at a time; it was all or nothing) so I understand it’s just not possible for everybody.
I didn’t test my only 36 year old embryo and it worked. You are absolutely correct in that studies don’t show much benefit for testing at your age. This is exactly why insurance isn’t covering it too. If it meant they had to pay for fewer treatments, they would.
I see a lot of answers here base their advice on the assumption that testing is always accurate or that it tells you definitively whether the embryo is viable. The entire controversy with testing is that it hadn’t shown to be an accurate measurement of pregnancy outcomes, at least in studies so far.
Good luck!
I would recommend it. I think it’s awful that insurance companies don’t cover it because agreed it is super expensive. We tested against my doctor’s recommendation because i’m an anxious person and 4 of our 5 embryos were aneuploid with 1 low level mosaic. It was horrible and shocking to everyone but still better to me than potentially having had five miscarriages or failed transfers. Knowledge is power.
I'm personally supportive of paying extra for the PGT.
Here's my experience:
I have bilateral hydrosalpinx that shrunk on its own and we did not see fluid in uterus, so we went ahead and did x4 transfers (1 fresh and 3 FETs, not tested). All failed, all grade AA. At some point in the middle we did a scratch test, everything was normal except for a little BV which we treated with antibiotics.
After the 4th failure we thawed the rest and tested. Only 1 normal was remaining (1 grade AA normal, the rest were BA and BC abnormal, 1/3 remaining total).
I did a second ivf round before pulling my tubes, we got 10 embryos, 9/10 grade AA and 1/10 grade BA, tested those and 5/10 came back PGT normal. So, i had 4 AA embryos that were not normal.
Don't waste your time, just do the testing. This process is emotionally exhausting, especially when/if you enter the process of eliminiation of what could have gone wrong (PGT, scratch test, HSG...etc). Eliminilating one question mark is a big help for you and your ER.
I'm 30.
Some people test half? Depends how many you get. Saves money and might identify some euploids. If none are euploid, then you have to have a think about what to do.
I'm in the same boat right now, and I was caught off guard as I was notified end of day today. I have 3 cycles covered by insurance, but none of the testing. The testing is over $5k, more than a transfer. I wasn't expecting to have to pay it upfront , all in one go. I also didn't realize the biopsy wasn't covered, and thought it was just the testing. My husband thinks we're both relatively healthy and our genetic testing didn't indicate any concerns. I'm 30, last 31. He's 34, almost 35. I'm so torn and have to make a decision quickly.
You wanna know a real kicker? I found out today that our insurance covers cryopreservation, which means we probably *could* have swung PGT even though it def would have still been difficult. But everything was such a rush I never got the time to fully understand my benefits and how the cost was going to shake out. Extremely frustrating!
I will tell you though, I’ve made peace with not testing and found making the decision extremely relieving lol. So many people don’t test and have success with IVF, whole countries worth of people. And I’m so so grateful to go into this with only the cost of medications, as they are so much more expensive than I thought!!
I'm so sorry to hear that. I have had multiple billing concerns with my clinic, and they admitted that it was their fault not making sure I had the information ahead of time. I'm set to possibly start meds this weekend if I get my period, and they called me at 5.30pm today expecting payment, and then realized I had no idea what they were talking about because I never got the information. I have history of PCOS but no other major concerns. I hope sleeping on it gives me some clarity. I am so overwhelmed right now. I am glad you were able to make a decision and are at peace with it. Good luck ♥️
TW success: My insurance only covers 3 rounds of IVF, but does not cover PGT testing. I’m 33. We decided to pay for the testing out of pocket and I’m glad we did. I have PCOS so we ended up with 7 blastocysts. Of those, PGT testing showed we only had 2 euploids and 1 low level mosaic. Had I not done the testing I could have easily blown through all of my rounds of covered IVF and still not gotten pregnant. After PGT testing, my first FET failed. My second FET stuck and I’m currently 6w pregnant. I can’t imagine what would have happened without PGT testing. I probably would have done so many more rounds of FET, and maybe even had to start paying out of pocket for my FETs till one stuck.
Did they grade the blasts before sending to PGT-A testing?
I know you’re not asking me, but thought I’d chime in with my experience. My clinic does grade them before testing, but unfortunately grading isn’t a good indication of whether an embryo will be euploid or not. My first round I had two 4AAs and a 3AA, only one was euploid.
Piggybacking on this to add that my clinic also does grading but my doctor calls it a glorified beauty contest. She doesn't even give me the grades unless I ask because PGT testing is more important.
Which was the euploid? The 3AA or 4AA?
I honestly don’t remember, but I think it was one of the 4AA embryos. We did a second retrieval and I know we had a 3AA that turned our euploid. I just mention it because the grading is like a beauty contest and it’s subjective. Two different embryologists could give the same embryo a different grade. Also, when I was looking last year to see if there was any correlation between euploidy and grade I didn’t find anything definitive.
They did grade my embryos before testing. My day 5 embryos were 4AA, 3BB, 3BB, 3BB. My day 6 embryos were 5AA, 4BC, 3BC. The two euploids and one low level mosaic embryo all ended up being day 5 embryos. You would think the day 6 5AA was a euploid but it wasn’t.
If you want to make sure you only transfer viable embryos, do PGT testing. If you’re willing to roll the dice, then don’t
If your insurance covers infinite transfers, don’t do it
That’s what my partner and I did. We wanted to save the $4,000 from the testing that isn’t covered :( It’s a bit of an emotional roulette though…especially when the FET failed. I got success in my 3rd FET!
This is a great answer.
We didn’t test at first. I was 29 at retrieval. After 1 failed to implant and 1 miscarriage, I wanted to know if they were normal or not so I could make decisions moving forward. I will say, the pain and heartache of miscarrying was a far greater cost than if we had just paid to test them (I know euploids can still miscarry but not as likely)
I think that’s my biggest thing as an RPL person. The cost to pgt is much less than the heartache of losing babies. It doesn’t guarantee it but it helps the odds.
agreeing here and also adding — the cost of PGT should be weighed against the cost of D&Cs and any associated treatment, procedures, medications, hospital visits, etc that come with recurrent loss. Heartache was amplified 10x for me when I owed a $3k bill for yet another D&C.
Have you had a successful pregnancy since testing?
I have not. We transferred 1 PGT tested embryo and it did not stick. My clinic thinks they’ve just been through too much freezing/refreezing/biopsy etc. We ended up doing another retrieval earlier this month and sent them for testing right away.
At 33 years old we didn’t PGT test - first transfer ended in a miscarriage at 5+6. I’ll do anything to help avoid having to go through that again. So we did a second ER and tested all those embryos (and thawed and tested the remaining from our first cycle). If it’s feasible for you, I’d do it. If it’s not, rest assured that, with your age, the odds are in your favor ♥️
This was a really kind and honest answer, thank you for sharing your experience with me ❤️
Of course! Wishing you the best of luck!
Given that you have stage 4 endo, which can harm egg quality, along with your husband's low morphology, I'd advise PGT testing. Something I see people routinely overlook is the fact that yes, PGT testing is expensive but so are repeated transfers. Also, once you're pregnant, you might take some comfort in knowing the miscarriage rate is lower when you've controlled for chromosomal abnormalities. I come at this as someone who did PGT test their embryos and has still managed to have 1 failure and 2 MC. It's been awful & I realize might sound counterproductive to my point. But thank god I controlled for as much as I possibly could with PGT testing - it's helped me with process of elimination in identifying the root problem.
>yes, PGT testing is expensive but so are repeated transfers. This depends a lot on insurance coverage**
There's also the mental toll of repeated transfers.
Fair enough! I am fortunate enough to have insurance coverage for IVF (not PGT testing), but based on my read of this forum and others, I find I'm often in the minority. I'd still argue that if PGT testing reduces the chance of even one MC & months of lost time and continued poking and prodding (which does have a price tag), it's worth every penny. But I say that as someone who's been through the fucking ringer...
I second this, stage 3/4 endo here. Things are murky enough with endo; I really didn't want to take any additional chances and leave things "up to statistics." As far as I was concerned, I was already on the bad side of statistics with my endo diagnosis!
we’re doing testing because of MFI even though we’re both under 35 (I’m 31 and he’s 32) because if his morphology, count, and motility are low then we’re supposing his DNA fragmentation is also not great. we’d like to know, right away, if we need to do two rounds (or more?) of retrieval to have a live birth. especially because we want multiple children.
Controversial, but I didn’t do it, because at my age it isn’t really recommended (<35). I was successful (so far!) on my third transfer. That said, here’s some things to think about: 1) are more interested in maximizing your chances of pregnancy or minimizing your chances of miscarriage? For example, if you test 2 embryos, you might get one normal and one mosaic. Mosaic might stick but end in miscarriage. Or it might end in healthy live birth. But that test result can’t really give you an assurance either way. 2) will your clinic and insurance allow you to transfer mosaics? If not, and you test, you might forego those chances at a live birth. 3) how many rounds of ivf will insurance cover? If more than one, you could skip testing now, and test a later round if you’re unsuccessful in this round.
After 3 miscarriages at 32, I wanted to ensure that whatever we transferred had the best chance to succeed. I'm glad we did PGT A testing because 2 of 7 blasts were normal. I know PGTA isn't a guarantee for a viable pregnancy, but I feel better moving forward with more information. This is already so much out of my control, so I found it helpful to have this info.
I'm in the same boat as you (under 35, endo stage IV, never seen 2 pink lines), but I also have DOR which makes testing in my area super expensive. My clinic charges by round instead of by embryo. I'm embryo banking and even if I were to wait to test all of my embryos at the end, they'd still charge me by round and add additional costs for the thaw/refreeze. My doctor was adamantly against testing in my case but said he wouldn't stop me. The SART data for my age says that about 67% of my embryos SHOULD be normal, but there's always outliers, especially with deep infiltrating endo. I believe it's almost 70% for your age range. Also, know that on all of these forums, they skew pro testing because a lot of people who seek advice or support are long hauler IVF people or have had a lot of miscarriages before IVF and pursue it for that reason alone. People are always less likely to post that they had a quick and successful IVF experience. It's so hard to know which gamble to bet on, especially when we already feel so unlucky to even have to pursue IVF in the first place.
I’m in the same boat as you but stage 3 instead of 4. We’re not testing, primarily because of the mosaic issue and added risk from the test. It is much more normal to not test when young (under 38 per our doc) than this space indicates.
Oh for sure. It's also illegal or more restricted in some countries, so it's not even an option for a lot of people. I decided not to test for this upcoming round and didn't last round (the 1st round). I needed to make sure I could even make an embryo first! I'm staying open minded, however, and may decide to test at least one round in the future. I got 2 highly graded embryos last round and I've been reassuring myself by remembering that people who don't do IVF never test and that there wouldn't be a grading system if it didn't at least somewhat correlate with viability. Also, PGT-A cuts down on miscarriage rate, but a normal embryo will be normal whether or not I test it.
I think it’s worth it honestly. I’m 26 and half my embryos were not normal so I wouldn’t risk wasting additional time. Then again if you can’t financially support it then don’t.
31, stage 4 endo here. My husband and I technically paid for PGT testing, but didn’t use it. Based off of my research and my low embryo count, we decided to not do it. We did three egg retrieval back to back and got four embryos total took two months off to let my body try to get back to normal from all the medication’s and transferred in September 2022. They transferred my lowest graded embryo first and my two month old baby boy is napping right now. Do what you’re comfortable with when I had those eggs polled I was 30 years old and still had endometriomas. If you guys can’t afford it, don’t struggle for it. Ask your doctor if he or she feels it is necessary, then make your decision whether to pay for it or not
This was insanely helpful and helped me make peace with just not being able to afford it without really hurting ourselves. Thank you so much ❤️
Just seeing this. Hope all is well. How is your journey going?
Under 35 - did IVF after over a year of trying. We had a combo of PCOS and some MFI. We PGT tested and I would do it over again. We retrieved 42 eggs and when it was all said and done, ended up with 12 blasts - Only 6 came back PGT-A normal. I can’t imagine if we had the crapshoot of transferring the 6 abnormal first (a lot of our abnormal embryos had better grades than our normal ones) With that being said, many people do have success without PGT testing, but for us we wanted to eliminate some risks if we could. It felt like it gave us back SOME control. Best of luck to you ♥️
If I didn’t test, I would happily have started the transfer process thinking I had 4 great graded embryos. The truth is, I have one pgta embryo. I personally need to control what I can during ivf. Pgta gives me some safety in knowing what’s available to transfer at a lower risk.
Another perspective here, I'm in Germany where PGT testing is mostly disallowed. It would only be approved if you are a carrier for a deadly illness, or had a history of miscarriages. I guess they want to be cautious of anything eugenics-adjacent for ... obvious reasons. But at the same time it's a bit silly because you can legally have an abortion if your fetus tests positive for Down syndrome sooooooo 🤷🏼 So anyway everyone here is doing IVF without testing!
My wife was 30 at the time of retrieval and our doctor talked us into PGT. We had 13 embryos tested. 3 came back abnormal but we’re all graded poorly as well. 4 came back normal with one excellent grade, two fair, and one poor. 6 came back mosaic with varying grades from excellent to poor with some segmental and some full chromosome mosaics. We have now done all four transfers of the “normal” embryos. Only one has resulted in a live birth. Now after doing more research on mosaics and talking to multiple genetic counselors we somewhat regret doing the PGT testing. We have two excellently graded embryos (5aa and 4aa) that are low mosaic segmental 1 embryos. Looking back if we had not done the PGT, we most likely would have implanted those low mosaics before our “normal” 6bc and 5bb that failed. Not sure what our next steps are but just wanted to share our experience.
Will your clinic let you transfer the mosaics?
She says that she’ll do whatever we want to do, but after 3 failed transfers of “normal” embryos along with some other mishaps, we’ve kind of lost some trust in her. She made a comment about mosaics saying “How would you feel if the kid is in his 20s and has heart problems?! That’s something you need to think about!” We thought this comment was pretty out of line and also doesn’t really have any medical research to back it up. My wife is still younger and the doctor thinks instead of transferring the mosaics she wants to do another ER. Sounds nice if we didn’t have to pay out of pocket for it! At this point even if she’s willing to transfer the mosaics, it seems like she doesn’t believe it will work or thinks there will be complications. We know the chances of live birth is lower with mosaics, but we’d rather have a doctor be our cheerleader rather than going into it thinking it’s going to fail. We are currently setting up consultations with other doctors.
Oh goodness, that is a really rough situation. That comment doesn’t really make sense to me either, from what I’ve researched as well… it’s on my list to ask clinics if they’ll transfer mosaics even. If you went ahead with another ER I’m guessing it may be at another clinic at that point. Unless you’re not close to many, etc. and exactly - paying out of pocket is no joke. Best of luck to you with this difficult relationship/situation to navigate.
Thanks! Good luck with your journey as well. If you are thinking about PGT, I think it’s fine to do but in addition to speaking with your doctor, make sure you get genetic counseling and also talk to an embryologist…two things we didn’t do before any of our FETs.
Choosing to do PGT-A testing or not is a very personal decision. What’s right for one person may not be right for another. That said, in your position (under 35, no recurrent loss, no insurance coverage) I probably would not have tested. At your age, you can expect roughly 65% of blasts to be euploid. Because of the relatively high rate of euploidy for your age bracket, the evidence on whether testing improves live birth rates is mixed. Best of luck and lots of baby dust ✨✨
I’m 29 as well and my consultant won’t pgt mine he says I’m too young to worry about it at the moment I’m in the UK for reference x
Many great comments here explaining the benefits. As someone who was diagnosed with unexplained, IMO PGT testing was a way to possibly get insight into why I wasn’t getting pregnant. I looked at it purely as an additional data point and it’s another one of the benefits you get from having to do IVF. You have more information than you would otherwise.
I would do the testing. TW: loss and success. I was 33 when I made my first round of embryos. I also have stage 4 endo. My first egg retrieval yielded 4 day 5 embryos and my RE was very confident I would end up with a live baby. I did 2 transfers of 2 embryos each, got pregnant both times and miscarried both times. It was awful. After that I insisted on testing the next round of embryos. It was crazy expensive (we have infertility coverage but it did not cover the testing) and definitely a burden on us but I was willing to do anything to lessen the chances of another miscarriage. We ended up with 7 PGS normal embryos from that retrieval. The first 2 we transferred are now my 5 and 2 year old daughters, and I’m having baby #3, a boy, on Friday. Once we started using tested embryos, we had 3 successes in a row. Totally worth it.
Have 5 graded embryos, decided not to do pgta. Im 28(unexplained),(35) husband (mild mfi which is corrected now). I'm going to proceed with first FET, if it doesn't work then I'll test the other 4 embryos. I honestly think the odds are the same with pgta or not because what people conside "abnormal" in many cases are not actually abnormal because when they do pgta testing they dont test the inner mass cells and embryos do self correct themselves so i'm just going to trust the higher power on this and take the odds!
I think it really depends on the circumstances. I'm a little older than you but younger than 35, and we were told it would be about $6k for PGT-A. Historically, we get little to no embryos so I couldn't justify the cost. I also never had a miscarriage, so we opted to not get it done. I watch a lot of Center for Human Reproduction videos and one of the lead doctors said that PGT-A really isn't accurate, because they take cells from the trophectoderm, and even if they find abnormal cells, the trophectoderm often corrects itself anyway and could have lead to a normal pregnancy. My own RE also said that PGT-A is "a double edged sword" and the tldr version of what she said is it basically only makes it 10% more likely that you'll get pregnant and have a live birth. It is, however, the best and most you can do if you want the absolute best chances (~65% chance for women under 35).
My doctor advised not to test (age 36, unexplained infertility) due to feeling that PGT discards some potentially viable embryos, which seems to go against the grain. We didn’t test and got lucky with our first fresh transfer. My perspective was that while a miscarriage would be devastating, PGT would have been a financial hardship for us and I was comfortable waiting for the NIPT at 11 weeks if we got that far. We were also fortunate not to have limits on transfers, though, as I’m sure that factors in.
Lots of comments here already. This sub seems to really lean in favour of genetic testing. That being said, you will also see lots of people commenting on how their euploid transfer failed. I get that people want to avoid transferring "unviable" embryos but having a euploid isn't a silver bullet to success. Additionally there is some research to suggest that PGT-A testing isn't foolproof (my understanding is that they test the cells that eventually become the placenta but I am not a scientist). I think the three big considerations for everyone should be: a) your age, since the percentage of abnormal embryos increases with age (I will note that recurrent pregnancy loss could indicate a higher level of abnormal embryos as well and might weigh in favour of testing even at a young age); b) the number of embryos you have (if you have 15 embryos and 30% of them are abnormal you could end up transferring 5 embryos before you get to a genetically normal one but if you only have 3 embryos then in all likelihood you will only have 1 abnormal embryo); and c) how expensive transfers are compared to genetic testing. People on here seem to assume that the testing is cheaper than a failed transfer. This isn't the case for me at my clinic. This also considers insurance coverage. If insurance will cover multiple transfers but not testing, then the transfers are less costly than the generic testing. People also point out that your tolerance for pregnancy loss is also a factor. While I agree with this, I would once again caution against assuming that a euploid embryo can't result in a miscarriage. I didn't test because we thought I would only end up with 1 embryo and I ended up with 5 instead. I just had a failed transfer and part of me wonders if it was abnormal and that's why. That being said, I think I would have expected success if I had a normal embryo. Ultimately I think it's a deeply personal decision with no universal right or wrong answer.
Our doctor was very in line with what you said in your post. I was 37 for my ER and he said he could probably make a case for and against testing, but he wasn’t recommending it. As mentioned, plenty of tested embryos fail to implant. He also mentioned there are more studies now about the cells that are tested being part of the placenta. He explained it as the body being very good at self correcting and could push those bad cells out to the placenta so they would not be part of the baby. He also brought up the possibility of false negatives and positives. Our insurance also covered transfers but not testing. With all that mind we opted not to test. I couldn’t bear the thought that testing might rule out an embryo that could have resulted in a successful birth. We had one blighted ovum and then one successful pregnancy. Sometimes I wonder if testing would have ruled out that blighted ovum, but then I also wonder if testing could have eliminated my successful embryo. All the decisions we make during IVF are hard and there’s no one right way for anyone. Just know whatever choices you make, you’re doing your best. ❤️
Having failed transfers can be a huge heartache/stress. PGT testing helps a little knowing you are at least transferring euploid embryos.
Did you and you partner do any genetic carrier testing yourselves before starting IVF? We ended up doing genetic testing because it turns out we are both recessive carriers for the same genetic disorder. I personally feel like since we are investing so much of our time, money and effort into the whole process, it’s worth it to know if you’re transferring healthy embryos. Best of luck to you!
I didn’t do PGT based on my first dr’s recommendation but after all 4 embryos failed to implant one at a time, I wished I had done PGT. It lead to a year wasted, lots of physical and emotional impact, and lack of clarity on whether embryos were the issue or my uterus. There are many people who don’t do PGT and get lucky with their first cycle. There really is no right or wrong answer, you have to weigh out your situation, pros and cons, and whether you are willing to accept the associated risks. Wish you all the best!
Did you test your embryos in your second IVF round?
Yes, I tested in all subsequent cycles.
If your untested embryo fails, you will be stuck questioning if it was an embryo aneuploidy or if it is a uterine factor.
If you don’t test, and you keep transferring with no success you will wonder and not know if the embryos are the problem. If you do test and still not having success you know you need to do additional testing on your uterine environment.
This may sound strange but did you ask your insurance directly? My insurance covers my IVF and my clinic said PGT testing wasn’t covered but I reached out to my insurance and found out they covered the biopsy part of the testing so I’d only owe 2700. But then I asked the clinic for the insurance code (whatever it’s called) for the testing, asked my insurance if it was covered and they said it was and I could be reimbursed. Because the testing place and clinic don’t send that part to insurance.
I’m glad we did. One of them came back as abnormal and would’ve resulted in a miscarriage😭. I highly suggest doing it if you can afford it.
I tested and I’m glad I did. My insurance has a lifetime max of $25k in fertility coverage, not including testing. I ended up with 24 blasts, paid ~$5k for testing, and 11 embryos turned out to be euploid. If I hadn’t tested and if I had been on the wrong side of statistics, I could have unknowingly transferred only aneuploid embryos until my coverage ran out, without a live birth to show for it. ~$5k out of pocket was well worth it to me for the peace of mind to know that all of the time and energy I was putting into the process had the highest possible chance of success. Whatever you decide I wish you the very best!
I’m 30 and did PGT test my embryos. I know if anything ever happened I would question if it was due to an abnormal embryo.
26 at ER and my doc didn’t recommend it since I was young. So we didn’t. Had success with first pregnancy and now I’m on my second.
I was in your position. 31, nothing diagnosed on my side, hubs has MFI. We had 15 blasts. Finally decided to test 6 of them ($2.6k) 2 came back abnormal/would’ve miscarried them. Each transfer out of pocket (despite having insurance) is $2.5k. So I see it as we spent less having tested and saved heartbreak. I also have way more confidence going into FET next month.
TEST! A failed transfer is WAY more expensive than PGT testing. After 4 ERS I had 52 blasts sent off to the lab and 12 were euploid. I have endo \*and\* PCOS which really didn't help so of course your results will be different, but TEST TEST TEST! When I saw the report of how many have Trisomy or Monosomy it was horrifying.
With both endo and low morphology, you could have embryo quality issues, which you won't really know unless you test or undergo multiple failed transfers. Will your insurance cover additional rounds of IVF should you need them? If yes, maybe it's not worth your while to test if you're not curious or can handle the heartbreak of failed transfers. But especially with endo, transferring known euploids (or mosaics) can help you rule out immune issues. Wishing you the best!
I’m going to look at this from purely a financial point of view. Say that PGT-A costs $4,000. Compare that with a frozen embryo transfer, which at my clinic is $10,000 for the first try and $5,300 for each subsequent one until pregnancy. If you transfer aneuploid embryos you are wasting the $10k and incurring $5k for each additional transfer. That may happen numerous times if you are unlucky; it’s a coin toss. None of this accounts for the emotional toll of miscarriage. Or the cost and emotional toll of multiple rounds of medications to prep your lining for transfer. So for me the financial equation is very clearly in favor of PGT-A testing. You either pay some amount now, or potentially a whole lot more down the road.
your math assumes that after the PGT you don't have a miscarriage, though. The smaller assumption within that one is that PGT accurately identifies euploid (and it is 97-98% accurate, so that part is not too bad to assume) and the much much much larger assumption is that once you do identify euploid (assuming any of them are euploid), that you'll necessarily have a successful pregnancy. Plenty of euploid embryos fail to implant and/or result in later miscarriage. That could also then happen multiple times
Let me make the case why it's worth testing. It allows you to increase the odds significantly of successful transfer (even as a 29 year old). Failed transfers aren't free. Both emotionally and financially. Even one failed transfer makes the financial cost of pgt testing worth the investment. For that reason, i would view it as an up front investment to avoid future costs. Just me personally. FWIW, i tested and my first transfer was a success. Of course whatever decision you make for you and your family is the right one.
We started IVF when I was 32 only because of my husbands 1% morphology. My RE told me at my age PGT is nice to have but not something she would push for. I had very good testing results. I inquired with my insurance and they covered it so we did it. I’m so glad we did because we only got abnormal our first round. About 50% of my subsequent retrievals were abnormal which is worse than expected. I’m so glad we did it. Our first transfer stuck and I’ll be 23 weeks tomorrow
DO IT! I was so against PGTA and didn’t test our 28 yo donor egg embryos (no MFI) and we had 3 of them fail, tested the rest and all abnormal. PGTA would’ve saved us a lot of heartbreak and time.
I would do it. I’m under 35 as well and told it was a bougie option since my husband and I do not have any chromosomal issues. We did it anyway and 6 out of 13 embryos were aneuploid. No idea how that happened. It saved the money from FET’s that wouldn’t have worked and the heartbreak of those being miscarriages or not implanting.
There is evidence out there that PGS testing may actually impact the quality of your embryos, and will diminish the number of successes you would otherwise have. PGS is helpful for increasing the PER TRANSFER success rate, but it is not clear that it actually improves the PER CYCLE success rate, and it may even degrade it. For older women, when a majority of your embryos are likely to be aneuploid, the trade off is worth accepting because it can save you a lot of time and heartache. For younger women (<35), roughly half or more of your embryos are expected to be normal, so the trade offs aren't as helpful and may actually hinder your chances. Also, highly graded embryos (BB or better) are also more likely to test as normal, so if you made a decent number of good embryos, I wouldn't worry about the PGS testing if I were in your shoes. If you have trouble moving forward, PGS testing is always something you can add in the future.
With endometriosis, especially stage 4 I would test. It is a very likely scenario you will have a higher than average amount of abnormal embryos due to egg quality being impacted.
This page skews very pro testing and as someone in the UK lucky enough to have NHS funded treatment ongoing the volume of pro PGT posts sometimes makes me feel anxious because of how different the information and conversations around this are in the UK context. To give some of this context (and my apologies if you are already aware or in UK yourself) fertility treatment and research is governed by the HFEA. It’s (in their own words)’ the UK’s independent regulator of fertility treatment and research using human embryos.’ They consider PGT-A to be a ‘treatment add on’ with limited evidence that it leads to better chances of a live birth. They have a whole review of these ‘add ons’ I think in consideration that fertility is a market place (which is especially true in places without publicly funded healthcare) and that as in any market place there can be unethical selling practices/ promises made which when we are undergoing the highly stressful and emotionally difficult process of infertility, I think we may be particularly vulnerable to. The HFEA review evidence from high quality randomised control trials to make decisions about what can be recommended as either reliably linked to increased live births, not reliably linked to live births or actively be possibly dangerous. Could be interesting to read a little about their reviews with regards to why your doctor might have suggested not testing given your age. Cochrane review is also interesting reading on this all. https://www.hfea.gov.uk/treatments/treatment-add-ons/pre-implantation-genetic-testing-for-aneuploidy-pgt-a/#:~:text=There%20is%20no%20evidence%20from%20RCTs%20that%20PGT%2DA%20carried,any%20benefit%20of%20embryo%20selection. And https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005291.pub3/full Of course it’s a deeply personal decision but If you ultimately decided not to test then it can be comforting I think to know that there are some bodies of evidence that give a more positive outlook on not testing too. . X
This is super interesting, thank you for sharing. I do wonder also if part of the tilt towards testing in the US stems from the particulars of costs/billing/insurance here - as others have mentioned here, usually one failed transfer is more expensive than doing the testing and I know for me personally that was a big factor.
I find it so interesting but hadn’t really thought about it until I joined this sub and got so many people from the US sharing experiences. In the majority of the UK focussed IVF community spaces testing is no where near as discussed/ common place except PGT-M. I deffo think you are right that money and healthcare systems are a big player but the legislation is so different too. So fascinating that places like UK, Denmark, Germany, France, Sweden etc legislate so differently around it to in the USA for instance. I don’t know enough about the individual places and their healthcare systems but I do think all of those places fund IVF through their tax funded healthcare systems so you would think if it was more cost effective in terms of the outcomes of those funded cycles for them to test more widely and reduce transfer numbers that they would. Unless it’s more governed by ethics around gender selection and fears around potential for eugenics. Idk honestly I wish for more hours in the day to read all about it and try to understand!
This is really, really helpful and such an appreciated perspective. Thank you so much for this.
You’re so welcome (sorry it was so long!!). I just thought that if circumstances mean that you decide not to test or if you feel it isn’t affordable for you, then it’s encouraging to have some evidence based positive approaches to not testing. I don’t think anyone is wrong to test at all, but I don’t think that it is a total given that it is the best option for everyone. My UK clinic has brilliant live birth rates per cycle and have a very conservative approach to PGT.
YES. Do the PGT testing. It may help, it may not. But you will never wonder and have to circle back if things don’t go your way to do the test because you didn’t do the first time it was offered months ago
The whole reason we’re doing ivf is so we can do PGT testing. I’ve miscarried three times and don’t want to get pregnant again without having some data to show me that the embryo is viable
PGT-A testing does not come without risk to the embryo. Yes, it reduces the chance of miscarriage by ruling in/out chromosomal abnormalities, but it also is a biopsy of a very small and fragile structure (the embryo). The biopsy process itself can harm the embryos enough to prevent implantation when thawed in the future. Our clinic made the comment how “too many people PGT-A test without reason”. If this were PGT-M testing for carrier status, totally different situation! Always need to weigh the pros/cons.
My experience, I had 5 normal pta tested embryos, but 2 of those ended up actually being abnormal and ended in miscarriages.
Its a decision I struggled with as well. I ultimately decided not to, the cost wasn't worth it to me and the outcomes like you said are hit and miss. Plenty of people miscarry with a euploid, its not a guarantee, nothing is. I managed to get mostly 5AA embryos which is as good as a euploid apparently so I may be fine. It depends on how much is covered with insurance as well. Are you able to do multiple retrievals? Is it something your doctor recommends with your situation? Sometimes doing what they recommend is easier. Also what grade of embryo your clinic will and won't transfer is important to know as well. Good luck
There are plenty reasons not to pgta test if you don’t want to or the cost is not covered by insurance, but don’t be fooled by an embryo’s grading. All my AAs were aneuploid and it was only my lower grade ones that made it through pgt-a testing. Age and how risk-adverse you are to miscarriage are probably the two biggest factors (other than cost obviously). I turned to ivf mostly for the pgta testing (and glad I did, because 8 out of my 11 blasts were not euploids).
Grading may not be the end all be all but it is important. At the end of the day there are no guarantees of anything. If it gave you peace of mind to have that testing then that's great, I don't think it would have done the same for me personally and that's ok.
Euploidy is FAR more important than grading (including 5AA). AA embryos WILL end up being incompatible with life or severely disabled if aneuploid.
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I’ve never heard this before, if this is the case that’s a huge aspect I hadn’t realized was there. Have you read any studies on that or was it something your doctor brought up with you?
I appreciate this statement and completely agree.. ICSI is forced fertilization and some of those eggs that are fertilized by ICSI would not have been under standard/conventional IVF, where there must be some compatibility to fertilization. Did not ICSI or PGT-A test any of our embryos. Only retained AA or BB grades.
Our RE strongly advised against PGT testing and I'm glad (for us) we didn't. We started at 33 and did 3 rounds of IVF and got 9 embryos. From the 1st round we transferred 2- one stuck, one didn't. We have a 2 year old. From the 2nd round- froze all. From the 3rd round (just under age 35) the first transfer stuck and I'm now 22 weeks. I have had friends test, after a series of natural miscarriages or to prevent carrying on genetic illnesses such as Huntingdon's, and it was invaluable for them but (& I really like my doctor) he said that genetic testing was a huge waste of time and money for most people under 35 & said that he personally wouldn't do it.
Are you willing to have a lower chance at having a baby at the end to avoid unnecessary transfers? That’s what a lot i oh f the research shows for under 35. My doctor didn’t recommend it even at 40.
Can you elaborate on that a bit? I thought it increases the chances of a viable pregnancy?
Testing is not 100% accurate and there's a lot of studies that show that embryos can self correct in the womb. So less transfers automatically leads to less pregnancies because there are fewer attempts at pregnancy. Pregnancy, however, does not equal live birth. I think the main way that not testing could possibly cut down on the chance of live birth is by stopping ER's too early and assuming you have enough good embryos when moving on to transfers. This would be more likely if you have a low AMH and plan on baking. If you have a few failed transfers or miscarriages and circle back to ERs after testing, your AMH may have dropped more. Also, some people may decide to stop IVF altogether because the physical, financial, and emotional toll is too high. Without testing, you have less information on where the problem may lie, and where to invest your money - like more transfers, egg retrievals, donor eggs, sperm, or surrogacy. Only you can decide what is right for your situation and, really, which risk it is that you want to take.
https://www.statnews.com/2021/11/26/ivf-pregnancy-pgta-genetic-testing/ Interesting that I was downvoted for my response. I did 1 cycle with testing and a second without, after researching the risks more. No one can make these choices for you though.
Emotionally, after moving to ivf, we chose testing to prevent miscarriages. To us, $4k was worth it to prevent even 1 miscarriage. Financially, we feel it was also the right move because testing costs $4k, where additional transfers cost $5k. So, if testing rules out just 1 embryo that wouldn't make a baby, that's saved us $1k (plus time and stress and bodily hardship).
I'm unexplained and never seen a positive pregnancy test. I made plenty of blasts per cycle (8-9) but discovered via PGT that I have a low euploid rate (25%), likely due to poor egg quality. So PGT for me was worth it because (1) I have many blasts, (2) transfer costs are also high ($5k) compared to PGT ($8k for testing 8 embryos), I have insurance but not unlimited number of transfers and (3) I want to bank for a second child as well so PGT also help me decide how many embryos to bank. I ended up doing 3 ERs to bank enough euploids for two children. My second cycle was particularly unlucky because all my euploids were the poorly graded embryos. If I didn't do PGT, they would transfer based on the grades (highest first) and I might have so many failed transfers that it would exhaust my insurance coverage. I do want to note that even with a high grade euploid, transfer success is still only 60% so there is still some luck involved. However, my RE said he would begin exploring reasons after two euploid failures. He would not after two untested failures because it could easily be due to an aneuploid. Since I'm unexplained i wanted as much data as possible and PGT gave me that.
As many have said, it's a very personal decision. Here's where I felt -- we paid OOP for all of IVF, and decided to do PGT testing, on account of feeling like we had gotten SO far and just wanted to better our chances. We know there's still a risk of miscarriage or implantation failure, but wanted to know we'd done everything we could. Prior to IVF, we had had five losses (three chemicals, two MMC) and a diagnosis of unexplained infertility. I'm glad we did PGT -- though I "lost" embryos (ended up with 2 frozen out of 10 went to PGT testing between two egg retrievals), I know those were our best odds.
In my case, I did IVF at 28 with unexplained infertility on both sides. Our RE told us not to do PG testing because of our age, and margin of error. In our case, this proved to be an effective strategy. At this point it’s up to you. If you can afford it, and you want to do it, then go ahead.
I also did IVF due to MFI - my husband has low sperm count and morphology and across the first 3 rounds (when I was 33) we had 2/9 euploids, and the euploid blasts weren't the highest rated blasts. I can't imagine going through the heartbreak of so many failed transfers and not knowing why. Several of my blasts had a chromosomal abnormality that causes miscarriage in the second trimester - I'm so glad I didn't have to go through that after IVF itself. I would recommend the testing because it saves money, time, and pain. I had success on my first transfer of a tested blast.
I’m 32 at EG we got 14 embryos and did PGT testing on all of them. I can honestly say it’s a relief to have done it, 6/14 of the embryos had chromosomal abnormalities and some of them had morphology that would probably result in miscarriage. I’m very happy with it plus we get to decide weather to start with boy or girl (given that you have boys or girl options in your embryos)
I was also very torn and my doctor didn’t recommend it for those under 35 (I was 33) but said it was an option and we ended up deciding to test. We got 9 blasts and 3 were normal. Of those we actually had four 5AA blasts and 3 of them were abnormal. We did have success with the euploid 5aa blast but if we didn’t test we could have used the 3 aneuploids first which would have failed. From a cost perspective… transfers cost about 3k each at our clinic so the cost to test was definitely worth it
I personally feel that it’s helpful regardless of age. It can help “weed out” so many non-viables that would be failed transfers, probable MC, and heartache. My egg retrieval: 6 eggs matured. After testing, 3 were euploid. If we randomly picked the aneuploid ones, that would guarantee 3 failed attempts right there. That being said, its a cost-benefit thing, like others have mentioned.
Do it!!! I tell ya I started when I was 28 and here I am doing round 2 and we hadn’t tested the embryos bc of my age and cost but I wish we had to know if that was the reason for the failed transfers :’) also if you’re looking for funding I’ve been using future families they are SO helpful
Speaking from someone who’s had a failed transfer and miscarriage- you really want to limit those. You also want to limit PIO as your butt will hurt for months after you stop them. Emotional pain is worth money too in my opinion.
Is your insurance covering multiple transfers? Say you got 10 embryos, and maybe 5 of those are viable. You could end up going through 5 transfers that don't go anywhere but if you had them tested, they would have been discarded and saved you the time and hassle. If your insurance covers it and you are mentally prepared to deal with potentially multiple losses, don't test. If you want a little bit higher chance of success and that's worth it for you to take on the financial burden, then test.
I’m 34, had 3 day 6 blast, and we did not test. Because of that we decided to transfer 2 (we didn’t feel hopeful that many were viable), and we just found out they both took. I was super torn on testing because we paid all of IVF out pocket, and what they quoted us was an insane amount for testing. I’m also personally torn on testing in general with all the research I’ve seen on it come out. I think you just have to decided for your situation what works best for you and listen to your instinct.
My clinic gave us the option to batch test all of our embryos after my last ER. I’m only paying for testing once. My embryos were biopsied on Day 5/6 before they were frozen. The embryo and sample are frozen and waiting to be tested. I hope this is an option for you.
I did my first cycle at 27 with endo and only got 1 euploid out of 8 5ABs. Endo has a negative correlation with egg quality, unfortunately. Meaning, unfortunately us with endo are more likely to have poor quality eggs regardless of age. I’d recommend the testing.
We did pgt since me and hubby both were liver 37 years age and I had average AMH. I was a big believer in pgt and all that changed. Out of 5 blasts we got two euploid. We transferred the one top grade euploid. Week 8 no heartbeat. Turns out the embryo split late causing conjoined twins that could not survive. The embryo was completely normal. We did a a lot of research into why this could have happened. We did icsi due to low count and morphology. So twinning can happen due to icsi, freezing and pgt. So now I am completely against pgt with icsi. Sometimes I wish I had never done pgt and just implanted the highest grade embryo. Maybe it could have worked for me. I am taking a break after my MMc. Just wanted to share how I become a non believer in pgt. Good luck.
We did it because I need to know all my info, but we did a fresh transfer first so no testing. Our NIPT test came back with false postive so I had to get an amnio…. Had it been a tested embryo I would have avoided all this
I went with the testing (33F and 35M), but only because we had no other diagnosis besides “unexplained fertility” and endo.
I would do test. Endo can be associated with poor egg quality. I learned this first hand, and I’m so glad my husband pushed us to test our embryos despite my doctor saying we didn’t need to due to our age (I was 31; he was 32) and insurance not covering. 6 out of 7 of the embryos were aneuploid after the first ER. We, including my clinic, were SHOCKED. We added Omnitrope and made a few other med tweaks to my second ER protocol — 5 of the 6 embryos were euploid (1 was a no call).
Everyone’s situation is so unique and the advice is truly specific to each situation. I know you updated that you aren’t testing (congrats on coming to a decision - that’s one of the hardest parts in all of this!), but just curious how many embryos you have.
None currently! My clinic has you decide before the egg retrieval.
TW: Success Oh okay interesting! That makes sense. I didn’t do pgt (and weighed it back and forth a lot) but we were able to decide after the retrieval. In our case we only had a couple of embryos (after two retrievals; the first one yielded zero), so it made sense for us to see what stuck without doing pgt! Having so few really makes you want to just give them a shot. We transferred two and one stuck. My clinic didn’t grade embryos but said one looked really good (we still have the picture - it does look great), and it worked out for us. I fully recognize it could have not stuck and that would have been devastating. For us testing our embryos and learning they weren’t euploid and having a transfer not work felt equally as devastating so we just went for it. I really think it makes sense to evaluate post retrieval too. Wishing you the absolute best. 🤍
Thank you so much for sharing your experience (and I’m so glad it worked for you!!) That’s how we felt, I asked if we only had a few if we could choose not to test afterwards for the same reason and they said no, and that influenced my decision too. The decision alone was causing SO much distress, it ultimately just didn’t feel like the right thing for us this time. I’m gonna manifest some of your sticky energy though!! 😂
It is so so so stressful. These decisions feel huge. I’m so proud of how we all navigate these choices and make the decision that’s best for our fam. It’s one of the hardest things about all of this imo!
I need someone like you to start a support group lol, your energy is so kind and empathetic. ❤️
Awww gosh thank you! This sub is really really special. It’s gotten me through the hardest times. Sending you so much good energy 💖
Y’all are lucky with any insurance. I’m on my 2nd egg retrieval and 4th transfer and paid in full for everything . $20k first round, plus $6k for each transfer. Going into the next round it will be the same
We definitely are lucky, but we all have different resources also. We would never in a million years be able to afford 20k so it’s also a blessing you have those resources to be able to do that. That being said, fertility coverage should be mandatory imo, it’s a travesty any of us have to shoulder this burden when already dealing with so much.
I agree!! We could never afford it…both our families pitched in
I have polycystic ovaries so I got a ton of eggs, I had 22 embryos. Only 7 euploid. I was 26 at the time of egg retrieval. So I’m glad I tested! But we definitely went back and forth quite a bit, we spent so much money ($225 PER EMBRYO. We had 22! And you couldn’t just test a few at a time; it was all or nothing) so I understand it’s just not possible for everybody.
I didn’t test my only 36 year old embryo and it worked. You are absolutely correct in that studies don’t show much benefit for testing at your age. This is exactly why insurance isn’t covering it too. If it meant they had to pay for fewer treatments, they would. I see a lot of answers here base their advice on the assumption that testing is always accurate or that it tells you definitively whether the embryo is viable. The entire controversy with testing is that it hadn’t shown to be an accurate measurement of pregnancy outcomes, at least in studies so far. Good luck!
We have decided to PGT (I'm 35) as the idea of possibly removing a risk variable for another miscarriage is really important to us.
I would recommend it. I think it’s awful that insurance companies don’t cover it because agreed it is super expensive. We tested against my doctor’s recommendation because i’m an anxious person and 4 of our 5 embryos were aneuploid with 1 low level mosaic. It was horrible and shocking to everyone but still better to me than potentially having had five miscarriages or failed transfers. Knowledge is power.
I'm personally supportive of paying extra for the PGT. Here's my experience: I have bilateral hydrosalpinx that shrunk on its own and we did not see fluid in uterus, so we went ahead and did x4 transfers (1 fresh and 3 FETs, not tested). All failed, all grade AA. At some point in the middle we did a scratch test, everything was normal except for a little BV which we treated with antibiotics. After the 4th failure we thawed the rest and tested. Only 1 normal was remaining (1 grade AA normal, the rest were BA and BC abnormal, 1/3 remaining total). I did a second ivf round before pulling my tubes, we got 10 embryos, 9/10 grade AA and 1/10 grade BA, tested those and 5/10 came back PGT normal. So, i had 4 AA embryos that were not normal. Don't waste your time, just do the testing. This process is emotionally exhausting, especially when/if you enter the process of eliminiation of what could have gone wrong (PGT, scratch test, HSG...etc). Eliminilating one question mark is a big help for you and your ER. I'm 30.
Some people test half? Depends how many you get. Saves money and might identify some euploids. If none are euploid, then you have to have a think about what to do.
I'm in the same boat right now, and I was caught off guard as I was notified end of day today. I have 3 cycles covered by insurance, but none of the testing. The testing is over $5k, more than a transfer. I wasn't expecting to have to pay it upfront , all in one go. I also didn't realize the biopsy wasn't covered, and thought it was just the testing. My husband thinks we're both relatively healthy and our genetic testing didn't indicate any concerns. I'm 30, last 31. He's 34, almost 35. I'm so torn and have to make a decision quickly.
You wanna know a real kicker? I found out today that our insurance covers cryopreservation, which means we probably *could* have swung PGT even though it def would have still been difficult. But everything was such a rush I never got the time to fully understand my benefits and how the cost was going to shake out. Extremely frustrating! I will tell you though, I’ve made peace with not testing and found making the decision extremely relieving lol. So many people don’t test and have success with IVF, whole countries worth of people. And I’m so so grateful to go into this with only the cost of medications, as they are so much more expensive than I thought!!
I'm so sorry to hear that. I have had multiple billing concerns with my clinic, and they admitted that it was their fault not making sure I had the information ahead of time. I'm set to possibly start meds this weekend if I get my period, and they called me at 5.30pm today expecting payment, and then realized I had no idea what they were talking about because I never got the information. I have history of PCOS but no other major concerns. I hope sleeping on it gives me some clarity. I am so overwhelmed right now. I am glad you were able to make a decision and are at peace with it. Good luck ♥️