To PGS or not to PGS

Today is the last day of my pre-IVF down regulation.  I took Androgel (testosterone) once daily, Prometrium (progesterone) 200 mg twice daily and Estrace (estrogen) 200 mg twice daily for 23 days.  My body will be resting for about a week.  Some of the side effects for me were nausea, fatigue and feeling down for no reason. 

My down regulation hormone medications

If the ultrasound and bloodwork looks normal on Friday, the ovarian stimulation (which involves several daily injections) will begin in exactly 7 days.  I’ve also purchased the most expensive fertility medications (Menopur, Puregon and Cetrotide) I will need for the ovarian stimulation from ivfmeds.com which saved me a couple thousand dollars.  They don’t carry everything I need so I will still buy the rest from the clinic.  I was hesitant at first to buy online but the savings is incredible.  I wish I had done that the first time.  They ship from UK and but charged US $99 express shipping.  It arrived in 5 days.

I’m having a hard time deciding whether to have PGS (Preimplantation genetic testing) or not.  It is supposed to prevent early miscarriage but it didn’t work for us the last time.  We had 2 chromosomally normal embryos in the last cycle, but one ended in early miscarriage (just short of 6 weeks) and the other one didn’t even implant.  Our doctor recommends it because we’re older and my husband’s sperm DNA fragmentation is not so good (even though it improved in the last 3 months after he took a lot of supplements).  Anyone over 35 years old has more than 50% chance of having abnormal chromosomes, and about 90% abnormal by age 40.  Those abnormal embryos usually end in early miscarriage and if it does become a successful pregnancy, has a higher chance of having a baby with Down Syndrome or birth defects, so it’s pretty scary.

Here are the reasons why I’m hesitating against PGS testing:

1.  Not covered by OHIP and it costs around $5000 and we can no longer afford this.

2.  The test is maybe 98% accurate but cannot test mosaicism. 

3.  Biopsy is taken on day 5 (blastocyst stage). But I’ve learned that abnormal embryos can self-correct themselves after day 5.

4.  At almost 40, my own egg(s) is more fragile and of low quality that the biopsy process can further do damage to the embryo.

I guess the only outstanding issue is to PGS or not to PGS.  If I don't do PGS testing, it's where my faith comes into play.  I need to decide in 7 days…