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Re: elevated AF AFP and re: pre-implantation diagnosisFrom: annette lee (aleeoc@rocketmail.com)Fri Mar 26 07:22:08 1999
Thank you for your opinions on the elevated amniotice fluid AFP with normal serum AFP. To answer the questions raised: the amnio was for maternal age 35, the triple screen was done even though amnio was planned because of the studies showing that elevated SERUM afp with nl amnio indicates increased risk of IUGR and IUFD. The report on the AF said "fetal hemoglobin = NEG". Interstingly, this patient has bordeline GDM with her first 2 pregnancies with abnormal 1 hours and 3 hours that had elevated 2 hour levels but all others nl. I wonder if there is any connection. About the pre-implantation genetic dx, in our IVF practice (2-300 cycles/year) we have seen several patients who have undergone PGD/embryo biopsy/IVF at other centers. Young women with good quality embryos, who did not become pregnant even after multiple transfers. I cannot help wondering if the process of doing the embryo biopsy damages the embryo, making it more unlikely to implant. Also, there are reported cases of INCORRECT idendtification of an embryo as "unaffected" and then resulting in the birth of an affected child. In our own practice, we have women with balanced translocations who have undergone IVF and then CVS to make sure the embryos that they are carrying are "normal". Ethical issues aside, I think that this is the best way to achieve a reasonable pregnancy rate while minimizing the risk of an affected child being born. The other option would be to use donor eggs....
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