Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics.

About a decade ago, I and my associate, Levent Keskintepe PhD were the first to introduce full embryo karyotyping (identification of all 46 chromosomes) through preimplantation genetic sampling (PGT) as  a method by which to selectively transfer only euploid embryos (i.e.

Apart from any fair dealing for the purpose of private study or research, no Abnormal +6 (male)

I try to avoid using such protocols/regimes (especially) in older women and those with DOR, favoring instead the use of the agonist/antagonist conversion protocol (A/ACP), a modified, long pituitary down-regulation regime, augmented by adding supplementary human growth hormone (HGH). Research suggests that that embryos with autosomal monosomy very rarely will propagate viable pregnancies. Aneuploid XY -4 Abnormal in most cases implantation will fail to occur and if it does, the pregnancy will with rare exceptions, miscarry. Have a question? Pregnancies have been reported following 2ndary biopsy/PGS. #3 is complex aneuploid and in my opinion should not be used. The subsequent viability or competency of the conceptus will thereupon depend on whether euploid or aneuploid cells predominate. Thank you. On the one hand, we strive “to avoid knowingly doing harm” (the Hippocratic Oath) and as such would prefer to avoid or minimize the risk of miscarriage and/or chromosomal birth defects and on the other hand we would not wish to deny patients with aneuploid embryos, the opportunity to have a baby. Research suggests that that virtually no autosomal monosomy embryos will propagate viable pregnancies. Thus, the transfer of such mosaic embryos is virtually risk free. Both are day 5 blasts graded 4AA. Chromosome 22 is one of the 23 pairs of chromosomes in human cells.Humans normally have two copies of chromosome 22 in each cell. #4 Monosomy 16 In order to best understand the complexity of the factors involved in such decision making, it is essential to understand the causes of embryo aneuploidy of which there are two varieties: 1. We want to hear from you.

• Blastocyst Embryo Transfers Should be the Standard of Care in IVF In a few rounds of IVF we have a few normal embryos but we have many more abnormal. Thanks, I PGS tested back in 2017 when ‘mosaic’ was not one of the options for classification. • Frozen Embryo Transfer (FET): A Rational Approach to Hormonal Preparation and How new Methodology is Impacting IVF. 08-AB normal XX ADDENDUM: PLEASE READ!! 1.) I would consider transferring all!Human embryo development occurs through a process that encompasses reprogramming, sequential cleavage divisions and mitotic chromosome segregation and embryonic genome activation.

Any remaining normal embryos will be kept frozen for transfer later if the first transfer is unsuccessful. Most complex aneuploidies are meiotic in origin and will thus almost invariably fail to propagate viable pregnancies. Please also take the time to post any questions or comments with the full expectation that I will (as always) respond promptly. Age 34. However, I advocate against this approach because a) the thaw…biopsy..refreeze..thaw for FET, is too traumatic and besides, b) if the embryo is transferred, and it is “competent”, it would be likely to propagate a pregnancy, anyway.

• The Fundamental Requirements For Achieving Optimal IVF Success Following that, would you consider transferring any of the other embryos below? Your feedback will go directly to Science X editors.

However, with the launching of Sher-Fertility Solutions (SFS) in April 2019, I have taken on a new and expanded role. We do not guarantee individual replies due to extremely high volume of correspondence. I think it worries her.

45,XX -8, dup (8) (q12q13),dup(8),(q24.2q24.3)

EUPLOID XX NORMAL 4. The most common reason for these "false positive" results is that a proportion of embryos are "mosaic"—they have a mix of normal and abnormal cells. Is it worth it to unfreeze and test the remaining embryos recognizing that this is a risk to the embryos? rare disease research! • The “Biological Clock” and how it should Influence the Selection and Design of Ovarian Stimulation Protocols for IVF.

In order to best understand the complexity of the factors involved in such decision making, it is essential to understand the causes of embryo aneuploidy of which there are two varieties: 1. The in-depth resources contain medical and scientific language that may be hard to understand. The recent introduction of a variety of preimplantation genetic screening (PGS) known as next generation gene sequencing (NGS) has vastly improved the ability to reliably and accurately karyotype embryos and thus to diagnose embryo “mosaicism”. This is in large part due to chromosome abnormalities. “Click” and you will immediately be taken to those you select. Aneuploid XY +16, -20 Complex Abnormal, Would you consider transferring any of these?

3. I have 13 embryos that have been tested, only 1 of which was normal. In fact, I am personally aware of several such cases having occurred in my own practice. Do you know of an organization? I did not do the PGS and I have 4 frozen embryos. Importantly, PGT-A doesn't "correct" chromosomally abnormal embryos, it simply allows couples to avoid transferring them. Your work is amazing! Many clinics recommend PGT-A for women over 35 (more than half of women who have IVF) and those who have had repeated miscarriages or failed IVF treatments. In order to best understand the complexity of the factors involved in such decision making, it is essential to understand the causes of embryo aneuploidy of which there are two varieties: those that have a full component of chromosomes) to the uterus. 1. We remove all identifying information when posting a question to protect your privacy. The coexistence of both aneuploid and euploid cells coexisting in the same embryo is referred to as “mosaicism.” Embryos are grown in the laboratory for five to six days. The lab report reads like this: 46,XY; del (13) (q31.1-qter). You need egg donation but if that is NOT an option for you then please consider the following: The older a woman becomes, the more likely it is that her eggs will be chromosomally/genetically “incompetent” (not have the potential upon being fertilized and transferred, to result in a viable pregnancy). Would you transfer any of these? Would you even consider this at all? • Blastocyst Embryo Transfers done 5-6 Days Following Fertilization are Fast Replacing Earlier day 2-3 Transfers of Cleaved Embryos. Thank you very much for your time and effort, your blog has been a huge help in our IVF journey so far. 1. 1. What should be done with “mosaic embryos? We have (2) low level mosaics; 2. no blastocist • Preimplantation Genetic Testing (PGS) in IVF: It should be Used Selectively and NOT be Routine. 2. Autosomal monosomic embryos rarely (if ever) proceed to birth.

our pgs report stated 80% confidence level.

• Hereditary Clotting Defects (Thrombophilia) 7.

While it is presently not possible by any means, to reverse the age-related effect on the woman’s “biological clock, certain ovarian stimulation regimes, by promoting excessive LH production (e.g. Also, is there a larger than normal possibility that the del(1)(pter-p13.2) makes it to live birth without self-correcting? Should we transfer either (or both together)? 5B BC, Day 6, 47 XY +12, Mitosure 0.72 Sex XX, Observation -16. So clearly, summarily discarding all aneuploid embryos as a matter of routine we are sometimes destroying some embryos that might otherwise have “autocorrected” and gone on to develop into normal offspring.

Thank you so much for your reply and advice; it means everything to me! XY complex abnormality Is transferring this embryo even a option. Advancing Age and Diminished Ovarian Reserve (DOR) Reduces IVF Success Rate She has had one 6 week miscarriage, 1 microdeletion on 11 with much involvement and one perfect child. Menopur) can have a negative effect on the development of the eggs of older women and those who have DOR and should be limited. The ability of mosaic embryos to autocorrect is influenced by stage of embryo development in which the diagnosis is made, which chromosomes are affected, whether the aneuploidy involves a single chromosome (simple) or involves 3 or more chromosomes (complex), and the percentage of cells that are aneuploid. Claire October 22nd, 2020 . Since some mitotically aneuploid (“mosaic”) embryos can, and indeed do “autocorrect’ while meiotically aneuploid embryos cannot, it follows that an ability to reliably differentiate between these two varieties of aneuploidy would potentially be of considerable clinical value. part may be reproduced without the written permission. Down syndrome, Edward syndrome, Turner syndrome). • IVF: Selecting the Best Quality Embryos to Transfer

Complex abnormal +13, -22 (male) In that same batch, I had two embryos designated as mosaic by Invitae: 46XY, del(7)(q21)(mos) – 5BC