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Thursday, August 21, 2014
Inherited Disorders and Birth Defects
Translocation and Infertility
I and my wife have been married for about 13 years. She had pregnancies three times, two of them occurred naturally (with no medicine) but they did not last more than two weeks. We know she was pregnant only by blood test. She had a trial ICSI. Her pregnancy test was positive during the first week, but unfortunately it did not last after the second week. As to my semen analysis, it is normal regarding the count but motility is reduced. I had some medicine to increase motility. That was in 2002, but now I don`t know my situation. Anyway, a doctor suggested that to have chromosomal analysis. The result showed that my wife has reciprocal translocation between chromosome 5 & 6. We tried PGD 4 times. In the first trial, only one embryo was found with no chromosomal problem, and put into the womb. We waited two weeks, but the test pregnancy was negative. In the other trials, no good embryo was found.
My questions: 1-Although we don`t use condoms or any kind of Contraceptives, she have not had a positive pregnancy test for about 6 years. Does reciprocal translocation cause infertility? 2-Does the percentage of successful PGD differ from hospital to another? I mean should we try PGD in different hospitals so that we would have a better chance? 3-After the trails we have made, do you advice us to stop trying PGD and go for adoption?
It is likely that fertility would be decreased by a reciprocal translocation, because the majority of embryos would have a chromosomal abnormality. However, other problems causing infertility could also be present, such as increased age and endometriosis. The success of IVF after PGD definitely differs from one hospital to another. Unfortunately, with a balanced translocation, the majority of embryos will have a chromosomal abnormality no matter where you go. The best way to improve IVF pregnancy rates when the female has a balanced translocation is to use donor eggs. A reasonable alternative would be adoption.
William W Hurd, MD
Professor of Reproductive Biology
School of Medicine
Case Western Reserve University