Comments on IVF Authority: Embryo Grading: CGH-Normal Blastocysts Have the Hi...

Hi Dr. Sher, I am wondering how long the CGH test ...

2010-12-31T12:11:48.892-08:00

Hi Dr. Sher, I am wondering how long the CGH test takes? We have always done PGD on day 3 with a day 5 transfer since you get the data back on late day 4 or early day 5. Can you help me understand that - particularly if we freeze and aren't bound to do a transfer by day 5.

Indeed, the poorer the morphologic quality (Grade)...

2010-08-10T10:49:31.354-07:00

Indeed, the poorer the morphologic quality (Grade) of the embryo the greater the likelihood of chromosoamal problems and aneuploidy. However, advancing age is an independent vatriable,such that even the highest graded day 3 embryos are more likely to be aneuploid. However, even beautiful looking embryos can be aneuploid and are more likely to ber so if derived from an older woman's egg. As an example; if 2 embryos are both of excellent grade on day 3 but the one (emnryo A )is from the egg of a 30 year old and the other (embryo B) is from an egg of a 45 year old, then the likelihood of embryo B being chromosomally abnormal (and thus not implant or result in a miscarriage would be about 8-10 times greater than for embryo A.

But you are right! There are no definitive studies to confirm the obvious.

Geoff Sher

Dr Sher, I understand that age is a known factor. ...

2010-08-10T05:22:01.153-07:00

Dr Sher,
I understand that age is a known factor. Given that, however, a woman of a particular age may produce at different times different quality embryos, which would be graded and known in the case of IVF prior to transfer, is there any known correlation between miscarriage rates and the actual grade quality of the embryo. For example, if a 40 year old woman achieves chemical pregnancy after the transfer of 3 top grade embryos, is she more likely to carry to term than that same woman achieving chemical pregnancy after transfer of 5 medium grade embryos?
It seems logical that this would be the case, but I can't find any studies that have explored this.

The commonest cause of both failled embryo implant...

2010-08-09T20:59:25.102-07:00

The commonest cause of both failled embryo implantation and of sponateous miscarriages is the same...chromosomal abberations (aneuploidy). Thus age is the common denominator. The older you get the more likely you are to have failed implantation as well as miscarriages.

Geoff Sher

Dr. Sher, Has anyone studied the correlation betwe...

2010-08-09T07:07:47.591-07:00

Dr. Sher,
Has anyone studied the correlation between embryo quality and miscarriage rates? It is clear that embryo quality correlates positively with successful implantation, but once pregnancy has been achieved, is there a positive correlation with rates of live births?

Lower yes. Absent chance..No! Geoff Sher

2010-06-11T15:38:17.667-07:00

Lower yes. Absent chance..No!

Geoff Sher

Hello, I am wondering if a blastocyst was graded ...

2010-06-10T14:02:32.446-07:00

Hello,

I am wondering if a blastocyst was graded AA by the Gardner grading system - does it have a lower chance of having chromosome abnormalities such as Down's Syndrome, etc?

Thank you for your response.

Laura

I cannot answer all the questions you raise. the i...

2009-09-20T11:00:45.086-07:00

I cannot answer all the questions you raise. the influence of exercise viamins, and stress etc, there is greatcontroversy about their benefit. A great deal that has been written is anecdotal and represents unvalidated opinion. As far as alcohol and tobaco---comon sense says avoid these after ebryo transfer.

I can tell you that when it comes to insuring the best treatment and the nbest possible outcome, it is very much dependent on the expertise, and skill of the medical and laboratory team and experience of the IVF center that you seek services at.

The factors that affect IVF outcome are a)those that impact egg/embryo quality ("competence") b)those that impact uterine receptivity and, 3) technical expertise of the treating team.Many of these are vspelled out in the articles on this blog, through several books on the subject and and through website information that you will find at sites such as www.haveababy.com.

Geoff Sher

Thank you as always for educating us on the newest...

2009-09-20T07:32:14.641-07:00

Thank you as always for educating us on the newest breakthroughs in fertility treatment,etc. I have read so much contradictory information from medical professionals and fertility clinics on the do's and don's during IVF that I need some clarity.

For example, besides the factors that we cannot, as patients, control (age, ovarian reserve, uterine competency,etc) what CAN we do do assure a successful outcome? Vitamins? Also, I have read that during ovulation stimulation a couple should abstain from sexual relations, is this true? What about following the egg retrieval and embryo transfer, how long must sexual relations be avoided? What sports and activities should be avoided and for how long. What about caffeine and alcohol, is it better to completely abstain?? For many of us, this is an incredibly stressful time as we cannot control many factors, so it is helpful to know exactly what we CAN do to maximize a successful outcome. Yes, I have heard many times to remain calm and not to stress too much, but your opinion on this could be very helpful. Maybe an idea for a future blog article.
Thank you!