Nobody puts abnormals back in

August 17, 2019 1:28 PM

"Researchers have begun to report preliminary but stunning evidence that mammalian embryos with abnormal chromosomes have the remarkable ability in some cases to “self-correct” during early development, either by editing out cells that possess chromosomal irregularities or isolating them in the placenta....Gleicher took the podium at the annual meeting of the American Society for Reproductive Medicine, the largest professional society of IVF doctors in the U.S. He announced, for the first time in a public setting, that the transfer of abnormal embryos had produced normal human babies."
posted by If only I had a penguin... (10 comments total)

He also rejects the notion that it [PGS] may have been responsible for the discarding of potentially viable embryos. “The lab makes the diagnosis,” he says, “and then the couple decides whether they want to transfer.” - Munné

While Munné, seems technically correct by saying that, he also seems to disregard how often people without any medical training, rely on those who do have such training.

I have no horse in this race, but I enjoyed the read nonetheless.
posted by honor the agreement at 2:52 PM on August 17, 2019 [2 favorites]

Yeah, that line felt very smarmy.

I'm hoping someone with some actual knowledge comes in here to evaluate the claims made in the article. Particularly whether it makes sense to transfer aneuploidal embryos that were NOT found to be mosaics. The article talks throughout at aneuploidal embryos and then it turns out they're defining that to include embryos known to be mosaics (That the U.S. just defined an embryo with even one abnormal cell as abnormal (or did in 2017). This isn't true everywhere (and may no longer be true in the U.S. So the article suggests embryos known to be mosaics are definitely worth a shot. Is the same true of embryos where all the biopsied cells were abnormal?
posted by If only I had a penguin... at 3:18 PM on August 17, 2019 [1 favorite]

It is not always the choice of the would-be parents. Some clinics will not transfer aneuploidal embryos. That is part of the risk of PGS testing.
posted by jb at 3:50 PM on August 17, 2019

NB: the clinic I know of will transfer "mosaic" embryos - ones which have some normal cells and some aneuploidal.
posted by jb at 3:52 PM on August 17, 2019

job: If you read the article, the U.S. system defined mosaics as aneuploidal. The results just say abnormal no matter how many cells were normal vs. abnormal.
posted by If only I had a penguin... at 3:57 PM on August 17, 2019

Braverman died earlier this year. Obit.
posted by gaspode at 6:12 PM on August 17, 2019

My heart hurts for people who didn't transfer "abnormal" embryos and now discover this.
posted by salvia at 10:57 PM on August 18, 2019

Heartbreaking to know so many potential children and parents were discarded due to this shitty test and poor response to it's results. Hopwfully moving forward doctors become more aware of these potentially viable embryos and less potential parents have to stay potential.
posted by GoblinHoney at 7:51 AM on August 19, 2019

This also raises questions about the efficacy of CVS, no? Since the outer shell of the embryo forms the placenta, and CVS samples the placenta.

Some of this article sounds highly overstated to me - my impression is that PGS is not standard for initial IVF attempts anyway. Some of this almost sounds adjacent to anti-choice rhetoric. Yes 40% of embryos may be discarded after PGS, but most couples don't use more than 1 or 2 embryos anyway. A lot of those 40 thousand discarded aneuploidal embryos would have been discarded anyway. If PGS isn't effective and doesn't increase IVF success rates, that's an important finding on its own; we don't need to appeal to the fear of discarded babies.
posted by muddgirl at 8:26 PM on August 19, 2019

Apologies for using "anyway" three times in 3 sentences.
posted by muddgirl at 8:52 PM on August 19, 2019