There are so many reasons to feel horrible when you’re struggling with infertility. Stress and guilt about whether or not to do embryo testing shouldn’t be one of them! I follow lots of fertility forums, and I’ve noticed recently that there are too many people feeling worried because they have risked having a child with a disease because they didn’t do a genetic test, or people feeling guilty that they did do a genetic test and ended up with no embryos.
Embryo testing is becoming more accessible these days, but there is still a lot of confusion about it.
Speaking for myself, I was totally confused. Before we did IVF, I thought that genetic testing was performed on every IVF round, so we had to decide whether we did or didn’t want it done. I also thought that it was primarily an ethical decision about whether we believed it was right to abort a fetus that was found to have a genetic abnormality.
Before we did IVF, I thought “Well, I don’t want to have a baby with an intellectual disability or with a serious illness, so I’ll get the embryos tested to remove that possibility”. My reasoning was, we’ve tried so hard for this baby, and paid so much, why wouldn’t we go the one extra step to test for any serious illnesses, for Downs Syndrome, Fragile X Syndrome etc.
As I quickly found out, it’s not that simple! (Physically simple, that is, not to mention emotionally, ethically, spiritually).
Your specialist is already doing a lot to make sure your little embryo has the best chance.
The first thing to know is that, in a regular round of IVF, your specialist is already making decisions between the different embryos to choose the healthiest one to implant.
The drugs pumped through your system during a course of IVF treatment massively increase the number of eggs produced during one cycle and so increase the number of possible embryos. Even though you’ve got many more embryos, the majority of the embryos produced don’t have any chance of ending up as a successful pregnancy because they have abnormalities in their genes. If these faulty embryos are implanted, they will end up as chemical pregnancies or miscarriages.
Obviously, when they have a choice of multiple embryos, the fertility specialist wants to choose the most healthy embryo to implant. They also want to remove the non-viable embryos, the ones that have no chance of becoming a baby.
How can a specialist tell which embryo is the healthiest?
One way of telling is to see which embryos grow fastest in the first three days, and then, if several grow fast, to wait and see which are still growing the fastest after five days.
Neat, half in half splitting is also an indicator of health, for example, an embryo that goes from 2 cells on day 1, to 4 cells on day 2, to 8 cells on day 3, is better than one that divides into an uneven number of cells.
Usually, this is the only selection method used. It’s generally accepted that the less interference with the early developing embryo, the better.
Genetic testing is not done unless the benefits outweigh the risks.
I didn’t realise it, but of course genetic testing is an invasive process. However it is done, material needs to be removed from the cells so it can be tested. The invasive prodding and poking into the cell can damage the embryo. If there are not strong reasons for doing it, your fertility specialist will recommend that you don’t go down the testing path.
Some people also have objections to genetic testing. These might be religious or ethical objections, or they might be absolutely sure they will go ahead with the pregnancy anyway, no matter what the outcome, so why risk an invasive procedure that could damage your precious embryo?
On the other hand sometimes there ARE great reasons for doing genetic testing. You don’t want to pass on a known disease to your child. If you’ve got a very high chance of genetic abnormalities, you want to be spared the pain of an IVF cycle certain to end unsuccessfully.
As it turned out, genetic testing was definitely not recommended for us, so it wasn’t a decision I needed to make. If I had known that up front, I would have been spared a lot of angst.
Next week I’ll talk more about the different types of genetic testing, and when they are used. It will hopefully help you get clear on whether genetic testing is on the cards for you or not. Facts, not stress and worry!
Blogger: Louise Dougherty