Ep 257: PGTA Reports Line by Line

Wondering what your Preimplantation Genetic Testing report means? Join Dr. Carrie Bedient from the Fertility Center of Las Vegas, Dr. Abby Eblen from Nashville Fertility Center, and Dr. Susan Hudson from Texas Fertility Center as they dissect the meaning of the PGTA report, line by line. They review what information the test provides and go through the nitty gritty of the detailed report. Listen in to this informative episode that shapes the next step in your IVF journey!

Episode Transcript:

Susan Hudson (00:01)

You’re listening to the Fertility Docs Uncensored podcast, featuring insight on all things fertility from some of the top rated doctors around America. Whether you’re struggling to conceive or just planning for your future family, we’re here to guide you every step of the way.

Carrie Bedient MD (00:23)

Hello everyone and welcome to another episode of Fertility Docs Uncensored. I am one of your hosts, Dr. Carrie Bedient from the Fertility Center of Las Vegas. And I am joined by my two absolutely awesomely incredible co-hosts, Dr. Abby Eblen from Nashville Fertility Center and Dr. Susan Hudson from Texas Fertility Center.

Abby Eblen MD (00:40)

Hey everybody.

Carrie Bedient MD (00:47)

How are you guys doing?

Abby Eblen MD (00:48)

Doing good. Trying to stay warm.

Carrie Bedient MD (00:50)

Yeah. So from the person who has lived in a desert climate the vast majority of her life, 100 % of the times that I had choices over where I lived, what do you guys think about snow? Yay or nay or meh?

Abby Eblen MD (01:13)

It’s pretty to look at, but in the South, we get some little bit of snow, but we really get more ice than snow. And the reality of it is, I know I’m going to work no matter what. I just get a little scared driving in ice, because even people that are from the North say it’s hard to drive in that kind of conditions, because you just can’t predict. So I like to look at it. I like to plan it for a day or two. And then after that, I’m like, I’m ready for it to be warm again.

Susan Hudson (01:39)

I agree. I don’t like ice and unfortunately most of the time when we do have snow, ice is actually our major problems because we don’t have the equipment to prepare roadways efficiently and effectively and so the world really does shut down and though that’s fun for maybe 24 hours, I prefer my snow to be somewhere I visit and then I don’t have to be at work on time or worry about getting people to wherever they need to be.

Abby Eblen MD (02:00)

Hahaha

Susan Hudson (02:06)

And so I like cooler weather, but not necessarily something where we’re going to have precipitation unless I’m visiting it.

Abby Eblen MD (02:15)

So Susan, I’m curious, when you lived in Minnesota, because that’s where you did your fellowship, right? So what was it like being there as opposed to being in Texas when it snows?

Susan Hudson (02:19)

I did. I mean, again, they have everything you need to get where you need to be. And so the roads are cleared when you need to be there. Of course, the first snow of the season is a little sticky, but it was great. There were wonderful things about it being snow and cold and those types of things. And so when we were there, we took advantage of it. One of my favorite things was coming home from work and getting a bottle of wine and sticking it in the snowpack outside your back door. It was like your own little wine chiller. It was fantastic. We went and did a sleigh ride and all those kinds of wonderful things, but it is much more fun if it’s a place that’s prepared and able to navigate it as compared to those of us who don’t live in that reality. How was it in Tennessee? I would think you would get a decent enough of snow that they would be prepared.

Abby Eblen MD (02:54)

Hahaha.

No, it’s exactly like you said. People always make fun of us because if there’s even a threat of snow, they close the schools down. One time I was in Sioux Falls, South Dakota, because my husband’s family farm, that’s the closest airport to fly out of. And we knew a blizzard was coming and we made it to the airport just in time. The blizzard hit. The planes from Chicago said, we’re not flying, we’re not coming there. But literally, like you were saying, we got a hotel, we went out to eat, we went to the mall. Nothing closed down and there was a blizzard. I felt like I was in middle of a snow globe in Sioux Falls, South Dakota, but nothing shut down. But yeah, our town, everything shuts down when it snows around here.

Susan Hudson (03:56)

Well, the funny thing was when we were in Minnesota, it was recently after they had switched the school buses to natural gas. Actually, natural gas doesn’t work that well in extreme cold temperatures. Most of the time when school got canceled, it was due to temperatures because the buses couldn’t run much. But the roads weren’t the issue. was literally they didn’t have vehicles to get people from places.

Abby Eblen MD (04:11)

wow.

Carrie Bedient MD (04:26)

Yikes. When I was in Cleveland, I remember there was one, it was some early snowfall in the season and it came down really hard, really fast, right at rush hour. And I was on a night shift at that point. So my husband drove me into the hospital and it took us 45 minutes to go about three blocks. And so I finally just jumped out of the car and ran the rest of the way to the hospital so I could get there to relieve my, people coming out.

Carrie Bedient MD (04:54)

And then in Atlanta, a couple of years later when I was in fellowship, we had snowmageddon. And it’s the same thing that you guys are describing. The South is just not equipped. There are two salt trucks in the entire state. And it just, it shut everything down. I was fortunate that I was not at work that day for whatever reason. And some of my attendings took 10 hours to go just to get home because I mean, cars were abandoned on the side of the freeway, people had to walk home. They’re just not equipped for it at all, which neither is Las Vegas in any way, shape or form. It’s completely fine with me because we don’t get that threat very often, but it is fun when you do get snow, because I live just a little bit higher up and you see the snow frosted palm trees.

Abby Eblen MD (05:26)

Hahaha

See, I would never have thought Las Vegas got snow at all until you showed me snow one time at your house. I’m surprised. I didn’t think Las Vegas got it.

Carrie Bedient MD (05:43)

Yeah, every couple of years we’ll get a snowstorm. But all right, so questions. What do we have for questions this week?

Susan Hudson (05:50)

All right, here’s our question for this week. Hi, I absolutely love your show. Think I’ve listened to almost every episode as I’ve been trying to conceive over the past year. Thank you for listening. I’m 32, husband’s 31, both in good health. I’m curious about your thoughts on my cycle length and if it could be our issue. My cycle is exactly 23 days, has been pretty much my whole life, but I’ve been consistently confirming ovulation on day 11 using the Mira device. Is it possible that my cycle is too short and therefore prevented pregnancy? We’d love your thoughts on how to proceed. Thank you.

Carrie Bedient MD (06:27)

What do you think, Susan?

Susan Hudson (06:30)

So I think cycle length is probably an issue and I would really want to know what your FSH is, your follicle stimulating hormone, because whenever I hear people having short cycles, it sounds like your luteal phase is good. The second half of your cycle is good, but your first half is not fantastic. And so I think we’re seeing some sort of functional egg issue.

And so an FSH would be helpful. I would often think that starting off with ovulation induction medicines like Clomid or letrozole. They tend to normalize a cycle length. So it actually may make your cycle length longer and improve your chances of success.

Carrie Bedient MD (07:16)

Sounds good. Agree, would definitely agree with all of that. You know, we really worry when the cycles are a little bit shorter that there’s some overlap in when the cycle from the prior cycle is resolving and also starting the next one a little bit early. So before your prior follicle is completely resolved, the next one is starting to go up, which is why we’re thinking about that FSH level and why it’s interesting to hear. I would be curious to know what that is, like Susan said, just to see, all right, are we starting to get premature growth before the prior cycle has resolved such that you should have the egg starting to grow along with the endometrium or the lining of the uterus starting to grow so that when the egg hits maturity and releases, it’s got a nice soft landing spot. Well, when you have the egg maturing faster, the endometrium is not quite as ready when the egg drops. And so it just doesn’t have a nice comfy place to land. And that can also really impair fertility. So I would definitely be curious about the FSH levels.

Susan Hudson (08:14)

So we just have to make sure that things go smoothly. And we also really prepare them totally. So we definitely have to careful about the application of this. Here, know, in situations, in some situations, for example, a short term, or sometimes it is a long term, it’s term. So we have to be careful about that. So we to about that.

Abby Eblen MD (08:22)

Yeah, and maybe not in this situation, but in some situations when cycles are shorter, sometimes it is the luteal phase that the issue. And so if you start having spotting kind of early in your cycle and have a shortened luteal phase, sometimes it may be worth by to check your progesterone level and even to add in some sort of progesterone supplementation to kind of lengthen the cycle if the second half of the cycle is shorter.

Carrie Bedient MD (08:43)

All right. So today, topic wise, we are going to go through what your PGT-A report is going to look like and what information you are going to get on that. Because it’s this black box of we say, OK, let’s see what your PGT-A results are. And many people don’t realize what information they will and will not get on that. And so first of all, just for any new listeners, what is PGT-A?

Susan Hudson (09:08)

So PGT is pre-implantation genetic testing. So this is where we sample the embryo, usually on day five, six or seven. We take a few of the cells that are eventually going to make the placenta and we have the embryo generally cryopreserved. Those cells are sent off to a lab for us to find out if your embryos are chromosomally normal or not. The A stands for aneuploidy.

Fancy word for abnormal number of chromosomes.

Abby Eblen MD (09:40)

And just one other thing about chromosomes, just to give you a little refresher on that, everyone should have 46 chromosomes. And if you think back to high school biology, they look like big Xs. And so you should have 46 of those. You get half from your mom, half from your dad. Typically, we worry when we have an aneuploid embryo, an embryo that doesn’t have the right number. Many times, unfortunately, it’s from the egg, because eggs, you’re born with all the eggs that you’ll ever have. And so is those eggs wake up at the time of ovulation or at the time of IVF trigger, all of a sudden they have to divide in two perfectly. And that only works about 50 % of the time, even in women who are very young. And so when we look at the chromosomes, we count the chromosomes, we wanna make sure there’s the right chromosome number. If you are 46XX, that’s a normal female, 46XY is a normal male. And so that’s what we’re really looking for with aneuploidy.

We’re going to talk in just a minute about when we look for genes and we’ll explain kind of where that fits on the chromosome as well in just a minute.

Carrie Bedient MD (10:36)

So when you are getting a PGT-A testing, what can you get that on? Like if you’re going through fertility processes in general, when can you get PGT and when can you not get PGT?

Susan Hudson (10:52)

For you to get PGT, you have to be doing IVF or in vitro fertilization. So we have to have embryos outside the body to be able to access the cells that we need. So either creating embryos or embryos that you may already have that’s cryopreserved.

But unfortunately, if you’re trying to get pregnant using anything like intrauterine insemination or IUI or doing timed to intercourse, neither of those are PGT available.

Abby Eblen MD (11:25)

And the other thing that has to be in place is you have to be willing to do a frozen embryo transfer. If you do a fresh transfer, which is what most of patients did for the first half of my career, we do the retrieval and just a few days later, after the embryos are created, we’re able to transfer the embryo. But in order to do genetic testing, we have to actually biopsy the embryos, freeze the embryos, and then it takes a few weeks later to get the results back. So we don’t have those results back in time to also then do a fresh transfer just a few days later.

Carrie Bedient MD (11:57)

So why can’t we do this on eggs?

Abby Eblen MD (12:01)

We can’t do it on eggs or sperm because in the process of trying to find the genetics, we would damage the eggs. We really have to wait till the chromosomes really coil up and are visible. And that’s only after we put egg and sperm together. And we know what the whole compliment is, the portion from the mom and the portion from the maternal side and from the paternal side.

Susan Hudson (12:20)

Also, while the embryos are forming, now we know most of the chromosomal abnormalities are going to innately come from the egg or the sperm itself. However, when all of the genetic information is getting shared between egg and sperm, sometimes we can actually have embryologic origins of aneuphoidy or abnormal number of chromosomes. So there’s a certain percentage we would flat out miss because the eggs and sperm hadn’t come together as one.

Carrie Bedient MD (12:52)

So when we are looking at the PGT-A report, when it comes to us and we get it, what is the information that you see on that report?

Abby Eblen MD (13:07)

So we have the name of the patient, that’s very important. And we literally have, it’s really kind of fascinating. It never gets old looking at these reports because we get such fascinating information, but literally each embryo is listed individually. So it’ll say embryo number one, and it’ll tell you how many chromosomes. So the right number is 46. It will tell you if the embryo is XX, normal female, or XY, normal male. If there’s any other changes like an additional chromosome or deletion of a chromosome or an addition of a piece of a chromosome or deletion of a piece of chromosome, it will give you that information too and tell you specifically where that area is. Every now and then we see an embryo that’s a mosaic embryo and that means that it has two different chromosomes in that same embryo and that can be confusing for all of us.

Susan Hudson (13:50)

We also can get information if there’s no information. Sometimes we go through the testing goes through the process and we end up not getting a result or it may be inconclusive. Also know that if you do not want to know the gender or genders of your embryos, you can request for that information to not be recorded. Now the Information is going to be available because flat out knowing if there’s the correct number of Xs and the correct number of Ys is part of the chromosomal analysis. We can’t not have that information anywhere, but you don’t necessarily have to have access to it.

Abby Eblen MD (14:41)

And usually we’re all very careful not to give you that information. In fact, I don’t really like to know, I don’t even like to have in my mind what the gender makeup is because I don’t wanna know, because I don’t wanna accidentally spill the beans.

Carrie Bedient MD (14:53)

You will never find a madder patient than someone who doesn’t want to know the sex of their embryo who has accidentally found that. It seems kind of surprising, but some of our angriest patients are people who find out information that they don’t want to find. Not that that happens terribly often, especially in a fertility office where we’re all pretty compulsive about not sharing that information, but sometimes we’ll have somebody come back from an OBGYN office where they were told that information without them really wanting to know it. So if you’ve got a report that comes back and it says normal, and if you look at the of the fine print of the report, there’s a couple of sections on there. There’s methods and limitations section. So let’s kind of start there. so when you get a test, is this test always a perfect result absolutely 100%?

Abby Eblen MD (15:44)

Nothing is ever 100 % in medicine. And so when we do the biopsy, our results are dependent on the cells that are biopsied. And so we always biopsy cells that are gonna be the future placenta. We don’t ever biopsy the cells that are gonna make up the baby. And so when we biopsy those cells, we get cells, if all those cells look normal, then we assume that the embryo created from the inner cell mass, the group of cells that we haven’t biopsied, we assume that those have the same genetics. And so we’re correct about 98 to 99 % of the time, but unfortunately, one to 2 % of the time, the cells that we take from the placenta are not the same genetically as the cells that will make up the baby. And so that’s the situation where we can tell you something and actually be wrong.

Carrie Bedient MD (16:28)

Okay. And in general, what are the accuracy rates of PGT-A?

Susan Hudson (16:35)

98 plus percent.

Carrie Bedient MD (16:37)

Does this mean that there’s absolutely no chance of an abnormality occurring?

Susan Hudson (16:43)

So no, so number one, realize that not all abnormalities or disabilities or however you want to categorize those things, not all of those things are related to chromosomes. And the only thing we are looking at is chromosomes. So there could still be gene defects. Say both parents are carriers of a recessive condition.

Ideally, you may have already gone through carrier screening to help minimize the risk of that happening. However, though most of us are doing panels that include 400 plus genes, there are still genes out there that are rare and sometimes that lottery gets pulled. And so that can happen. Also know that embryologically as a baby is developing,

structural abnormalities can occur that have nothing to do with things and have nothing to do with chromosomes. And so sometimes a baby may have a heart defect or another type of birth defect or develop some sort of challenge such as autism that we don’t have exactly what those things are related to at this point in our technological advances. And so a chromosomally normal PGT-A tested embryo does have a higher likelihood of resulting in a healthy baby, but it is not 100%.

Carrie Bedient MD (18:16)

And then looking at overall percentages. So we talked about, know, 98 % plus accuracy in results. How is the way that sperm is introduced to the egg, how does that impact that diagnostic accuracy? Does doing ICSI where you directly put the sperm in there, does that make it more or less accurate?

Abby Eblen MD (18:40)

Well, good question. I think it probably makes it more accurate because you only take one sperm and you put it inside the egg. I’ve certainly had patients that worry that our embryologists are picking the sperm when they take a single sperm and put it inside the egg. But generally when our embryologists pick the sperm, they pick the sperm that looks the best, swims the best, is the most handsome sperm, and hopefully more likely to result in a healthy pregnancy. But by taking one sperm, we know that more than one sperm is not getting in, and therefore that probably enhances the ability to get normal results.

Susan Hudson (19:12)

However, we used to make it protocol that if you were doing IVF with PGT-A that you had to do ICSI. And I believe as we are getting more and more data with improving biopsy techniques, there’s really becoming less of an issue when it’s specifically PGT-A. Now, we’re not going to really address these other types of PGT.

But PGT-M and PGT-SR that are looking for very, very, very specific things on genes or very small abnormalities on chromosomes. In those situations, I would say universally across the United States, everybody would agree that you need to do ICSI for that. However, ICSI is not required nowadays for PGT-A in most circumstances.

Now that can vary from clinic to clinic and technique to technique, but it’s not an absolute as it was, say, 10 years ago.

Abby Eblen MD (20:14)

Well, just the one reason that we think everybody sort of leaned toward doing it more commonly too, is every now and then you’d get a few people in a year that would go through IVF, we would retrieve eggs, we’d put them with the sperm in the Petri dish, and then we’d come in the next morning, there’d be no fertilization. And unfortunately, once that window of time passes when the egg and the sperm have to be introduced together, if that doesn’t happen, then there’s no going back. You don’t have great success rates then the next day trying to put one sperm in the egg and bring about fertilization. So that was part of the reason we started doing ICSI from the beginning and also for really low sperm counts as well. But then like Susan said, we’ve extrapolated it now we do it more commonly for also this situation with PGT-A.

Carrie Bedient MD (20:57)

When you look at these reports and there is an abnormality reported, will it tell you what exactly is going to happen with that embryo? So let’s say you have an embryo report that comes back as abnormal because there is an extra chromosome number 19 or any other random number. What information does the report give you about, this is what your baby or a pregnancy would potentially look like.

Abby Eblen MD (21:28)

So it really doesn’t give you that information. It just tells you that it’s abnormal. And so many times if we think that all the cells have that abnormality, usually your reproductive endocrinologist would not recommend that you transfer that embryo because that’s an embryo that most likely is not gonna result in a healthy pregnancy. Certainly if you have a situation where you have a mosaic embryo, where there’s some cells that are abnormal, we think, and there’s some that are normal, that’s a different situation because in that situation with the mosaic, there is a reasonable chance that that sometimes that patient can, as the embryo grows, the cells will be kicked out and the normal cells will continue to flourish. And so if it’s a mosaic embryo, a lot of times I’ll send patients to a genetics counselor just to talk about, okay, what would be the worst case scenario if this embryo turns out to have this abnormality? And if a patient feels like that they still want to transfer that embryo in that situation, I would recommend doing it. Whereas if an embryo is completely genetically abnormal in every single cell, I wouldn’t recommend transferring that one because I think the chances of a normal pregnancy are almost zero.

Susan Hudson (22:28)

Since we’re talking a little bit about mosaicism, another thing to know is that different platforms, the word mosaicism can mean different things. So on some platforms, mosaicism is something that we see, but there’s a reasonable chance that the results are not actually true for that embryo in that if you transfer a mosaic embryo, the most likely outcomes in those platforms are no pregnancy, miscarriage, or a normal live birth. Whereas there are some newer platforms that mosaicism, when it is reported, and in those platforms, it’s reported on a much lesser degree.

then those things are more likely to be true mosaicism where really we are more concerned about potentially having a child born with a chromosomal abnormality and those sequelae.

Carrie Bedient MD (23:36)

So who controls how this test is done? Is it your doctor that is running this? Is it their lab in-house that’s doing all of this?

Abby Eblen MD (23:51)

Generally not, generally there’s an outside source that the cells are shipped to and the analysis is done through that source and they choose a platform that they use as far as testing.

Susan Hudson (24:02)

And that decision can somewhat be made based on your clinic and laboratory. But it may also, that decision, if you have insurance coverage, may be made by your insurance company. If you have insurance coverage, there’s a very real likelihood that your physician can only use one, two, or three labs available in the United States.

Abby Eblen MD (24:11)

Yeah.

But overall, what I would say about that though is count yourself lucky if you have insurance coverage, even if you can’t control every single decision, all these platforms are still very good. Otherwise you’re gonna be paying thousands of dollars out of your pocket to choose somebody else if you don’t like the platform that your insurance provides for you.

Carrie Bedient MD (24:44)

When you get these reports back and it says no amplification or no amp or no results, what does that mean about the embryo? What does that mean about the information you have?

Abby Eblen MD (24:55)

It really means you have no information. You really don’t know anything. It’s really kind of like an untested embryo. It just means that basically for whatever reason, the cells didn’t grow or they couldn’t figure out from what the information that they had, what was in the cells. So in that situation, a lot of times the company will retest those cells, do another biopsy on those cells, on that embryo and retest the embryo again. And I usually tell patients if they’re willing to do that, I think it’s a great idea. The downside is the embryo has to be thawed out again and re-biopsied. But still, if you get useful information and find out the embryo’s normal, it still would be an embryo, it would definitely be worth transferring at some point.

Carrie Bedient MD (25:33)

If you get no results, does that mean that embryo is bad, for sure?

Susan Hudson (25:37)

No, absolutely not. And depending on your age, statistically, if you’re under 35, I believe there’s some papers that say it’s more likely to be chromosomally normal, but I wouldn’t hang my hat on that. I would statistically know that there’s about a 50-50 shot if I’m under 35, that this embryo is chromosomally normal, and a 50-50 shot that it is chromosomally abnormal. And so I think…the decision, if you would have even asked us three, four years ago on whether or not to re-biopsy three, four years ago, we would all be like, go ahead and re-biopsy. And there’s newer information that’s saying that it’s not necessarily hugely harmful, but there is some decreased chances in pregnancy. And so what I’m often doing nowadays is saying, okay, we have this untested embryo, let’s…go through our tested chromosomally normal embryos first, see where we are in your family size, family decision making, all those types of things. And then if we end up getting to that last embryo, then we sit down and talk about, do we want to transfer essentially an untested embryo? Do we want to rebiopsy the embryos? Talking about those pros and cons.

And I would say that’s a conversation that I expect changing even on a yearly basis with the way technology is evolving because realize the techniques that we’re using now aren’t necessarily going to be the same techniques we use in two, three years from now.

Abby Eblen MD (27:14)

Yeah, the one thing I would consider though, to what Susan said, if you’re under 35, it’s like having an untested embryo, 50-50 chance it’ll be genetically normal. As you get closer to 38, 39, 40, you’re looking at a higher percentage chance that the embryo is genetically abnormal. And so, again, like Susan said, it’s something you have to decide on your own, but if you really wanna know the genetics, I think I would probably test it and that way you may save yourself from a lot of heartache if it’s genetically abnormal in your 40 or something and save money in that way too because you won’t end up doing the transfer.

Carrie Bedient MD (27:48)

Mm-hmm. When you get these abnormal results, do they tell you where the abnormality comes from? Like, let’s say you’ve got too many, too few chromosomes. Will it say, it’s because of the egg, it’s because of the sperm, it’s because of whatever?

Susan Hudson (28:01)

That depends on the testing company and what level of testing you have paid for. So the answer is maybe. Most of the time, if you’re getting plain old PGT-A, no, you are not going to get that information. It actually takes an additional step in which we get genetic material from you, usually from a cheek swab that is also sent with your with your embryo sample. And so if you haven’t had a cheek swab the answer is probably going to be no.

Abby Eblen MD (28:34)

Well, there’s really not a big need to do that, except in certain circumstances. And like the one I’m thinking of mostly is if you say you’ve been through IVF before and you have really poor fertilization and you maybe you’ve maybe done it a couple of times and you have poor fertilization. So, you know, it’s not just a fluke. And so you’re trying to figure out, okay, we really want to have a baby. This is an eggs issue or is this a sperm issue? And that’s where it can be really helpful for you because then it can help you decide, if you’re willing to do this, that, okay, if this is a sperm issue, maybe we don’t use my partner’s sperm. Maybe we use donor sperm and do another IVF cycle. Or if it’s my egg, maybe we use an egg donor. And that way it can really help you pinpoint. In most situations, it’s not really critical that you know that information. So for most patients, we don’t generally do that.

Carrie Bedient MD (29:16)

So we’ve gone through a bunch of the information that you see and what that information does and does not actually communicate in terms of normal versus abnormal results, whether you know where they come from, how the test is done, what it means about accuracy, a lot of the things that are written in the fine print of the test. Can you guys think of anything else that we haven’t gone through yet that we should have?

Susan Hudson (29:39)

I think those are the big things. Remember, it is a screening test. It is not 100%. And so when you get pregnant and you go on to see your OB-GYN, who’s going to be delivering your baby, I still encourage patients to go through the screening that’s available in the first and second trimester, whether it’s blood tests or anatomy exams with the ultrasound.

I still encourage people to be doing that testing because there is power in knowledge. Just as you are getting power in the knowledge that you have chromosomally normal embryos, there is power in making sure that result is truly what we expect.

Abby Eblen MD (30:25)

Yeah, and the other thing I would add too is the reason to do, if you’re trying to grapple with should we do genetic testing, the reason to do it is because if we know that we have a genetically normal embryo, really regardless of your age, and we transfer that embryo back in you, you have a better than a 50 % chance, like a 66 % chance of having a live born baby if we know we’re transferring a genetically normal embryo. Even in the group under 35, normally we say it’s about a 50-50 chance. So even in that, the group that has the best prognosis, it still bumps your chances by about 15 % to transfer genetically normal embryos. So it’s very useful information and it saves you potentially even in the younger age group from doing multiple transfers because we would only transfer one embryo at a time. If you have six embryos, you might potentially have six transfers. Whereas if we genetically test those embryos, about half of those statistically are going to be abnormal ones that you would never want to transfer. And so it just gives you more useful information.

The better we can pick the embryo, the better your chances are for successful conception.

Carrie Bedient MD (31:26)

Excellent. Agree with everything. All of it. All right. Well, thank you so much to our audience. Thank you for listening. Subscribe to Apple Podcasts. We have next Tuesday’s episode pop up automatically for you. Be sure to subscribe to YouTube. That really helps us spread reliable information and help as many people as possible.

Abby Eblen MD (31:45)

Visit Fertilitydocsuncensored.com to submit specific questions you have and sign up for our email list. We look forward to hearing from you.

Susan Hudson (31:53)

As always, this podcast is intended for entertainment and is not a substitute for medical advice from your own physician. Subscribe, sign up for emails, and we’ll talk to you soon. Bye!

Abby Eblen MD (32:04)

Bye.