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Eeyore

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Wednesday, February 2nd 2011, 8:50am

ARRAY CGH STORY

FROM TODAY'S DAILY MAIL



A couple who tried to conceive for a decade have finally been blessed with a 'miracle' baby thanks to a pioneering new genetic screening process.


Lancashire couple Andrew and Louise Riley welcomed baby Elliott into the world just after Christmas after opting for a relatively new technique called array comparative genomic hybridisation (CGH).


Doctors used a genetic embryo screening process in advance of regular IVF treatment.





'Miracle': Baby Elliott Riley was conceived thanks to advanced genetic screening

Embryos produced by the couple during fertility treatment were analysed to check for chromosomal abnormalities.


The embryos were grown for five or six days to blastocyst stage and then analysed in the laboratory to check all 46 chromosomes. Only those fully healthy embryos were considered suitable for IVF transfer.


Chromosomal abnormalities are a major cause of miscarriage and the chance of abnormality increases significantly with a woman's age.


In the latest technique, array CGH was used to test the embryos but then the cells were also cross-matched against DNA samples taken from the mouth cells of Mr and Mrs Riley.


Mark Sedler, consultant fertility specialist at the Care Fertility clinic in Manchester, said this is the first time such 'parental support' has been used with array CGH, offering greater accuracy.


'This has never been done before,' he said.





Delight: Andrew and Louise Riley had Elliott after undergoing array CGH

'This can give us a percentage confidence for the genetic testing.


'It can tell us whether the abnormality comes from the mother, from the father, or from both.'


While this detailed information will not be of use in the current cycle of treatment - abnormal embryos will be discarded - it can inform future treatment.


For example, if the abnormality comes from the man, there is a possibility couples may opt to use donor sperm in the future.


Mrs Riley, 37, and her husband, 39, said they were delighted to welcome Elliott on December 30.


She said: 'The last 10 years have been a very emotional and difficult period of our lives.





Advanced: The Riley's underwent the treatment at Manchester's Care clinic

'We have been unable to conceive despite undergoing numerous tests and a failed cycle of IVF.


'Many friends and family have had children during this period and whilst being extremely happy for them, it was heartbreaking for us.


'We approached Care as a last hope.


'On 30th December we were finally blessed with a baby son Elliott.


'We find it hard to express just how happy we are as he is our little miracle.


'He means everything to us and our thanks go to Care and our family and friends for all their support.'


Mr Sedler said: 'Louise and Andy have endured years of infertility and failed treatments, a situation common to many couples.


'Chromosomal abnormalities account for a large proportion of failed IVF cycles and miscarriage.


'This very early screening test allowed us to replace only chromosomally normal embryos.


'We are delighted that Elliott has brought such joy to mum and dad.'


Mr Sedler said the type of screening meant the anxiety over whether IVF would work is cut.


However, the technique is expensive. It costs £8,500 including the cost of IVF, genetic testing and freezing of spare embryos.


Mr Sedler said the treatment could be particularly useful for older women and will lead to more successful single rather than twin pregnancies.


'We are getting ever closer to the safest and most effective form of treatment for the patient, aiming to achieve a single, ongoing healthy pregnancy per treatment attempt,' he said.


Mr Sedler said 75% of patients treated with array CGH at Care, who each had one embryo put back, have now delivered a healthy baby.


Stuart Lavery, consultant gynaecologist at Imperial College London, said: 'This research is exciting and what these live births are doing is adding to the debate and the evidence base for this technique.


'But before this is widely transported, it needs to be confirmed in larger trials.'


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Wednesday, February 2nd 2011, 8:59am

Hi
This is the screening we had and Mark Sedlar is one of our best friends and a great doctor. Unfortunately for us 3 of our embryos were abnormal and one didn't have enough tissue on the sample to test properly so we don't know either way about that one. But we are having it transferred tomorrow with everything possible crossed.
The good thing about Array cgh is that if all embryos are abnormal you don't go through the 2ww wondering and hoping only for it to fail.
It is expensive but we were lucky enough to be part of the trial so the screening didn't cost us anything we just paid for the ivf cycle.
I would recommend it to anyone with repeated failures or miscarriage or anyone over 40 because at least you know what you are dealing with instead of going into the transfers blind. You will also know any pregnancy that takes will be completely normal so no need for any other testing.


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Wednesday, February 2nd 2011, 2:28pm

After three failed cycles this was suggested for us at Bridge Centre. We chose to explore other tests first, but I would still go back to this. You can't get it here in Ireland currently, so that would mean Care or Bridge as I believe there are a tiny number of clinics doing this currently. I would also say go for it. I may still be going for it, but it seems the extra tests have unearthed one or two issues for me that I would have to have sorted, even with the screening! At least I know.

Good luck to anyone going through this. It's expensive but I think well worth it.

x


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Wednesday, February 2nd 2011, 8:57pm

Hi ladies,

Do you know the difference between CGH and PGD? Are they the same thing?

xoxo
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Blue

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Wednesday, February 2nd 2011, 9:06pm

Do you know the difference between CGH and PGD? Are they the same thing?


Hiya Rii,
Have you seen the discussion here:
chromosome 16 problem
The very wise Ruthie and Ros have mentioned PGD and CGH.
B
x

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Wednesday, February 2nd 2011, 9:10pm

This is not widely available and it is only available to those who are good responders - i asked care about it and was willing to pay for it but they say it is not available any more!!! It was just a trial - and that was from care at manchester!!! (Not however Mr Sedlar)

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Wednesday, February 2nd 2011, 9:17pm

Thanx Blue for the link it was helpful...what i am confused about is that me and DH both did the karyotyping tests and we were both normal...that is the chromsome testing right? I think it is.

I asked Dr. Gorgy what are we gona look for if we dont have any specific known diseases and that is when he mentioned CGH and testing all the chromosomes in the embryo...

Will i benefit from this ?
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Wednesday, February 2nd 2011, 9:19pm

Gosh. I thought care were the leaders. Is it available at other care clinics? Nottingham?

Rii, I believe pgd removes a cell from the embryo whereas cgh looks at the 'waste' after cell division. They each have their own pros and cons. Ha e a look at the thread recommended. There is also a fair bit on the Internet about it. If you want more I'll see if I can locate what bridge gave me by way of explanation. X


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Wednesday, February 2nd 2011, 9:22pm

Thanx Sammy anything would help...i will see Dr. G next week before i leave to Dubai. But he really confused me cause he kept saying CGH then PGD as if they are the same thing. ?o(
ICSI 1-April 2010 BFN
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Wednesday, February 2nd 2011, 9:23pm

Rii. You may benefit. Cgh uses the waste from the cell divisions so it contains the full set of chromosomes. These are then analysed for problems. As eggs age they can be abnormal. Not from genetic issues, just from quality and missing chromosomes etc. It's pretty much a way to assess quality. It's not always the good embryos under a microscope that are best. You want the ones with the correct chromosome pairs. If the next immunology cycle doesn't work I'll be considering this.
Xx


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Wednesday, February 2nd 2011, 9:30pm

Rii, I don't think cgh can can be used from some of the genetic problem screening as effectively as pgd, but it's been a while since I saw a genetic counsellor. Did dr gorgy recommend speaking to a genetics counsellor? Is he recommending this as he can't think of anything additional from a drug perspective? It is used where there are suspected quality issues. Pgd came about from looking at preventing transfer of embryos with chromosomal issues, where the issues are k own from the parents.

It's best to talk to a professional! I'll look for more info tomorrow for you! X


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Wednesday, February 2nd 2011, 9:41pm

He was recommending it because of two reasons:

Out of 10 only 2 made it two blastocyte and not the best grades (one grade CC and one early blasto graded DD) . And 6 x 8 cells stopped growing on day 3.

Also due to DH's low sperm count he wants to make sure we have good quality embryos and they are not being compromised due to DH's sperm.

I will make sure i ask him more questions next time i see him. I was surprised when he recommended it today and was not prepared so didn't ask much. ?o(

Thanx sammy! xoxo
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Wednesday, February 2nd 2011, 9:49pm

That makes sense Hun. Not sure how he can tell if it's the sperm causing the issue. Maybe because of the xy? Sorry, I went straight to egg quality as that's my concern. Goodluck and I'll write something more intelligent tomorrow. Go and have a :hugs:

X


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Wednesday, February 2nd 2011, 9:52pm

well i do have low AMH...so i think egg quality might also be a concern! So my eggs are also misbehaving! :snigger:
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Wednesday, February 2nd 2011, 9:59pm

X


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Friday, February 4th 2011, 8:14pm

There was an article on cgh on bbc this morning (avaliable on iplayer) it is good that it is in the media to raise the profile of this treatment. x
6x cycles of clomid bfn
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Friday, February 4th 2011, 8:16pm

I agree Louise! x


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