# EC with just 2 eggs - should we pay for PGS or let nature take its course?



## Jess2010 (Jul 6, 2010)

I'm hoping to get some of your opinions on the dilemma we are in at the moment.
I had my EC today, only 2 eggs out of 4 follicles (I am 42 and AMH dropped from 10 to 3.8 in 12months)
Our Consultant advised PGS as it would rule out any chromosome conditions and save me the agony of another transfer which resulted in a BFN or miscarriage.
Although DH sperm is low count / poor etc, this is my 3rd fresh IVF (1st got me DD, and 2nd had 3 x blasts put back graded B/C which didn't even implant)
So, I don't have a history of miscarriages etc, I think the Consultant just wants to eliminate any further risks if we do get pregnant.
The embryologist came up and discussed her thoughts - ie no point in doing PGS on what is just 2 eggs (still need to see if they are mature and if they fertilise) and her recommendation would be to put both back at day 3.  With PGS you can get 3 results, normal, abnormal and no result - so there is still a chance that we won't know if it comes back as a no result.  Also there is a risk at pushing the embryos to blast and that they might arrest before hand.
The consultant, when reviewed my file, still said that it was worth doing PGS even if there was only 1 embryo and that he prefers you to have them put back as a FET.
Also, we are moving onto DE next, would be different if we were going to bank the embryos before doing the transfer.  Also, PGS costs £3.1k which is a huge chunk towards the next treatment with Donor.
So, do we just let nature take it's course (my first ICSI was a day 3 transfer on a grade B embryo which gave us our DD - so miracles with poor grades can happen) or do we forget about the cost and focus on knowing the chromosome make up even though there is still a chance of a no result, no implantation and other potential conditions (according to some articles - it doesn't guarantee a successful outcome).
Really would love to hear your thoughts as we are struggling and minds keep swaying one way to the next.
Thanks
Jess


----------



## Beside_the_seaside (Oct 9, 2012)

I've had this type of discussion about PGS in circumstances when I was not likely to produce many eggs.

I could see that there MIGHT still be an argument in favour of it, if you were intending to do another fresh cycle with your own eggs in the event that this cycle fails.  For example, a worst case scenario might be that say you put these 2 embryos back, one or both implants successfully, but sadly due to chromosome anomalies, the pregnancy fails to progress and you have a miscarriage at 8, 9, 10 weeks or so.  Then - never mind the emotional fall out - you are in the position of having to deal with the miscarriage, recover physically, then sit out 1 or 2 cycles before being able to try again.  That might be several months lost - perhaps 4 or 5 months lost - which is time that (entirely depending on your own perspective of course) you might feel that you would prefer not to sacrifice if you wanted to try again with your own eggs.

On the other hand, you mention that IF this cycle is not successful, you would want to try again with donor eggs.  In that case, I don't think that saving time has the same significance at all.  In fact, it might be useful to allow yourself some additional time to prepare emotionally before moving on.

On balance - in your position, I would definitely go with what the embryologist suggests, save your money and have both embryos put back on day 3.  With 2 eggs, it's not worth the risk of damage to those precious embryos (however small), nor the risk of 'no result' which would leave you no further forwards anyhow.

Obviously these are just my personal thoughts - feel free to dismiss them as complete nonsense!  I wish you all the best whatever you decide to do.  Main thing - I do hope that THIS cycle is successful, however you achieve it.


----------



## fififi (Mar 16, 2011)

From reading your post you sound like you are thinking more to the "nature" option.

In your shoes from what I've read in your post I'd be leaving the PGS. You don't have history of MC & you've already decided that if a future cycle is needed you'll do DE so knowing whether your OE embryos are good or not won't affect future cycles.

The gamble you're taking by not doing the PGS is that you will have a higher risk of MC compared to doing the PGS. Getting a BFP then miscarrying later on was for me far, far worse than getting BFN. But at the same time I am glad I did get pg as the weeks it lasted were wonderful. Even with a PGS result of normal there's still some risk of MC.

Sadly like everything else in this crazy ivf world there's no clear obvious choice. Both have advantages (& disadvantages) so it really comes down to which option would you have the least regret choosing.

Maybe list advantages/disadvantages of each option & put star next to the aspects that are most important to you?


Hope you reach a decision you're both comfortable with & more importantly I hope you get good news about fertilisation and a BFP that results in a baby x


----------



## Artypants (Jan 6, 2012)

Hi there

My tuppence would be to save the £3100 on pgs with only 2 embryos, I think realistically at 42 the chances of abnormalities is fairly high and they may not survive the procedure. That's what I would do anyway, I didn't have pgs on any of my OE embryos and the 2 pregnancies I managed naturally were sadly abnormal which is what moved me-onto DE which was successful first time.

Sorry for being negative but its an awful lot of money and I would say go for it if you were talking about 5 or 6 embies. I really hope it all works out for you x


----------



## Jess2010 (Jul 6, 2010)

Thanks Fififi, Beside_the_seaside and Artypants for your quick replies and thoughts - to be honest your heads are exactly where mine is starting to align.  Especially as we already know we are moving to DE next.
I'm prepared for no embryos or a BFN already - I suppose the bit we both haven't really considered is a miscarriage so that is something we will need to discuss.
I agree that the embryologist is 'technically' the most trained and would have the best opinion on the embryo. I suppose the consultant is coming from the perspective of me perhaps and my body is there is a miscarriage.  I'm also remembering that he had initially discussed that we do around 3 cycles which is why the PGS cost was to test up to 9 within 9 months. I wonder if he would change his advise if he knew that this single cycle was all or nothing for us with OE and we are not planning on any more treatments after this.
Thanks again to you all ;-)
Jess


----------



## Beside_the_seaside (Oct 9, 2012)

I was just reading your comment:

"I'm also remembering that [the consultand] had initially discussed that we do around 3 cycles which is why the PGS cost was to test up to 9 within 9 months. I wonder if he would change his advice if he knew that this single cycle was all or nothing for us with OE and we are not planning on any more treatments after this."

I would guess that the answer would be yes, your consultant probably would change his advice if he knew you were only planning one cycle (retrieving 2 eggs) rather than several cycles. The idea of freezing embryos retrieved from each of several cycles, then saving them all up to PGS in one batch, is something that was discussed with me a while ago.

In the circumstances, I'd definitely go with what the embryologist recommends and save your money - because it is a LOT of money for no real advantage to this cycle. Assuming both eggs fertilise, and you put them both back on day 3, you haven't risked PGS procedure damaging the embryos (although the risk is very small) and you haven't risked them arresting in the lab by taking to blast - assuming there's credibility in the theory that they're probably better off in you, than in the lab.

Wishing you the very best of luck for a sticky BFP this time.


----------



## fififi (Mar 16, 2011)

Thinking of you & your news this morning - hope it's a good phone call xxx

PS agree with what besidetheseaside says


----------



## Jess2010 (Jul 6, 2010)

Thanks fififi and beside_the_seaside for your messages again.
Just had the call and both eggs have fertilised - it's the first time I've been buzzing in over s year as I feel we've just got through our first milestone. 
I said that we would like to do a day 3 transfer and the embryologist agreed that with such a small number that is the best option.
Really appreciate you helping me clear my head - fingers crossed 1 or both get to day 3 now ;-) xx


----------



## fififi (Mar 16, 2011)

Delighted to see you've crossed first hurdle ok. Looking forward to seeing more happy updates from you as you progress


----------



## Jess2010 (Jul 6, 2010)

Quick update - day 2 - 4 cells on both one as a grade 2 and other as grade 2/3. So not great but embryologist said to transfer tomorrow day 3 is their advice - so all steam ahead for being PUPO tomorrow


----------



## fififi (Mar 16, 2011)

Will be thinking of you tomorrow - hope ET goes smoothly x


----------



## Jess2010 (Jul 6, 2010)

Just thought I'd update - but we've got a BFP!! In total shock and pretty stunned as the odds were totally stacked against us (only 8%). Just hope we get through to  at least 12 weeks as the miscarriage risk is 50%.
Can't praise Manchester Care enough - we had the same embryologist that helped us get our DD so praying it's a good vibe.
X


----------



## fififi (Mar 16, 2011)

Congratulations   
Really thrilled for you.

You've got 50% chance it's a healthy baby and those are pretty good odds compared with what you started with   

How exciting !!!


----------

