PGS: Reasons For Considering Doing Chromosome Testing (PGS) Along With Your IVF Cycle

Published: 12/11/2015

1. Remember, the single most important reason for a failed IVF (implantation failure) and/or first-trimester loss (miscarriage) is that the transferred embryos were chromosomally abnormal. This is critical.
2. By doing chromosome testing (PGS) along with your IVF, ACFS has not only been able to significantly increase a woman's pregnancy rate (20+% over conventional IVF) but also significantly reduce the risks of a first-trimester loss (which typically is 20+%).
3. It significantly reduces the costs of IVF. By testing all day 5 embryos or blastocysts and finding the chromosomally normal ones, the couple will hopefully get pregnant on their first attempt rather than "statistically" having the do multiple transfers (FET-frozen embryo transfers) to "stumble" on the "chromosomally normal" embryos. Also, you may not have to pay for cryopreservation of abnormal embryos that you "did not know about."
4. By only transferring chromosomally normal embryos, a couple will not only eliminate the risk of having a chromosomally abnormal baby (Down's Syndrome, etc.) but also never have to face the decision of whether or not to terminate a baby with Down's Syndrome or any other chromosome abnormally.
5. Age disappears as a factor. By doing chromosome testing (PGS) and subsequent FET, ACFS is no longer worried or considers age a factor. ACFS statistics are not based on age but only on whether or not a woman can do an embryo transfer.
6. Learning possible reasons why other infertility procedures like IUI and multiple attempts at IVF have failed.
7. As part of the treatment for repeated pregnancy loss (RPL). 70-80% of first-trimester loss or miscarriage is due to a chromosome abnormality. A woman could significantly reduce the risk of RPL by doing chromosome testing, given all other causes have been eliminated.
8. By knowing if your embryos are chromosomally normal, you eliminate transferring embryos that will not implant, miscarry, or worse, result in an abnormal baby. This eliminates "hoping it will be successful," the progesterone in oil shots, the "long" wait for the pregnancy test, and most importantly, the disappointment when it is negative, and the ensuing emotions of an unsuccessful IVF cycle (not to mention the cost of possible multiple embryo transfers).
9. Eliminating the need for and associated risks of amniocentesis or CVS — reported complications occur in 1:300-500 patients that could result in pregnancy loss, not to mention the very difficult decision to terminate a pregnancy if the amniocentesis/CVS is positive.
10. By doing chromosome studies, the embryos are biopsied on day 5 at the blastocyst stage, cryopreserved by vitrification, and subsequently transferred in prepared cycle — FET. Our experience shows that pregnancy rates are lower when embryos are transferred in a fresh cycle that has been physiologically overstimulated (to get multiple eggs). In other words, based on ACFS experience, a frozen transfer (FET) is more successful than a fresh transfer.
11. Chromosome studies can significantly reduce the need to use donor eggs. It can answer if you have "good" eggs/embryos or not, rather than automatically going with donor eggs because of age, elevated FSH levels, and/or low AMH levels. ACFS has found little to no relationship between elevated FSH and/or low AMH levels but has found a relationship between elevated FSH and/or low AMH and age. A lot of ART clinics routinely turn these patients down and say that their only option is donor eggs. Respectfully, ACFS disagrees. Sometimes, these clinics seem to be more worried about their own success rates than taking care of the patient and doing what she wants. Even with elevated FSH and/or low AMH levels, ACFS still has shown success using the patient's own eggs.
12. It significantly helps to improve success rates in reproductively older women. It is ACFS’ experience that the incidence of chromosome abnormalities increases with age, and the reproductively older woman may only have 1-2 "chromosomally" normal embryos (although they may have produced a lot more blastocysts (or day 5 embryos)).
13. Gives the couple valuable information about their IVF cycle. In ACFS experience, the most common cause for embryos to fail to develop to day 5 or the blastocyst stage ("stall out") is due to the embryo being chromosomally abnormal.
14. Gender selection chromosome testing allows you to determine the sex of each day 5 embryos or blastocyst to determine family balancing.
15. You can plan your reproductive future. By knowing if you have any remaining chromosomally normal embryos, you can decide if you can wait to have another child or if you will have to stimulate again sooner.
16. Some early speculation, although not substantiated, is that certain IVF stimulation protocols may increase the risk of chromosome abnormalities (or aneuploidy), and also decrease embryo "competence" (producing an embryo that is chromosomally normal but of lesser quality and therefore does not implant and/or is at higher risk of miscarriage). By doing chromosome testing, you would rule out at least the first possibility.