PGD (Pre-Implantation Genetic Diagnosis)

[Andi71]

I'm 38, had three unsuccessful IVF treatments 1 in Hungary & 2 in the UK and about to try once more in Valencia/Spain (for the last time I think/hope).  Today at our initial consultation the clinic in Valencia said that the reason the embryos did not implant before could be because of poor egg quality in the first place.  I was surprised at this since in the past I was told the embryos were of very good quality every time.  Of course they were never checked for PGD (Pre-Implantation Genetic Diagnosis) and I never even heard of this test until today.  My question is should I or shouldn't I let the clinic perform a PGD to find out whether the eggs are genetically normal? I'm scared of the outcome. i.e. damaged embryos or no embryos to transfer. Has anyone in my age group had this test done and what was their pregnancy/live birth success?  Any info. or advice would be appreciated.

[Elaine Brown, MD]

Hi!
The biggest factor in IVF success is egg quality (not embryo quality) and the biggest factor in egg quality is mom's age.  There are other factors in both.  
As you are probably aware, PGD is a procedure in which one cell is taken from an early embryo and genetic testing is performed.  This can be useful in deciding which embryo/embryos to transfer and how many to transfer. If you are a "good responder" and get lots of eggs that fertilize and become lots of embryos, PGD can be useful in deciding which embryos to transfer.  Removing one cell does not seem to drastically reduce the success rate, and it can prevent children with birth defects, as well as multiple fruitless transfers.
On the other hand, it can cause loss of embryo/s or damage them.Also, results from the PGD are not a total guarantee.  If you only have a few embryos, and are going to transfer all of them anyway you may not want to go with PGD.
Finally, if you do PGD and find that a very high percentage of embryos are abnormal, it could help you decide whether to pursue egg donation.
I hope this helps!
Good luck!
Dr B

[Andi71]

Thank you very much for your response Doctor Brown.  I will wait to see how many embryos we'll end up with but if there are only a few, I will not go for PGD.  Should I ask the clinic to test the egg quaility only?  I normally have around 12 eggs after stimulation.
Kind regards,
Andi