Doctors' Report

Well, we had the two consults and all things considered, it looks like we have a few more tests that can be done before we have to make some big decisions. We went in thinking that we would be talking about a second IVF cycle, but the RE is against that at this point because we had such a high percentage of abnormal embryos. (Even though three embryos passed the PGD testing, the doctor thinks there is a fair likelihood that all three had undetected abnormalities -- either something in one of the chromosomes not tested or something in one of the cells that wasn't in the biopsied cell.)

So the next stage for us is to try to isolate whose genes are mucking things up. The greater suspicion is with Evelin's eggs, but there is a chance that it could be with my sperm. If it were a problem with me, our options would be a lot simpler (donor sperm is quicker, cheaper, and a lot less medical intervention than donor eggs), so we're starting with a couple of tests. First a sperm aneuploidy test will be done at the clinic, and then they'll send a sample off to South Dakota for a sperm chromatin structure assay (SCSA).

The science on this is still in flux (and the clinic is planning a wide scale experiment for next year or so), but there seems to be correlation between high percentages of aneuploidy and high percentages of DNA fragmentation. If either problem is evident in the sperm, it could explain the range of chromosomal defects that showed up in the embryos we got with our IVF cycle. One of the embryos was XYY and another XXYY, which are defects in the sex chromosome transferred from the male side, so there are some indicators that the problem could be me.

The other theory is that the mechanism in Evelin's eggs that assigns chromosomes to cells could be misfiring, which is possible considering the range of defects that the PGD discovered.

At this point, I'm going in on Monday to give a sample and then two to three weeks later we should know whether or not the problem is me. If it is, the first option is donor sperm. If it's not, we can do tests on Evelin's eggs, consider using donor eggs, or start talking about adoption.