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Dr. Richard Scott Answers Questions From Viewers
A team of NJ researchers claims to have developed a new technique that enables them to screen the full genetic make-up of an embryo before it is transferred. Perri Peltz reported on their research on Wednesday's "New York Nightly News." After the show, one of the doctors behind the study, Dr. Richard Scott, participated in a live chat on WNBC.com. Below are some of his responses from last night's chat:
Doctor_Scott The study will be recruiting patients in the next few weeks and will start entering women into treatment in January.
Doctor_Scott The patients needs to get seen in our practice so that we can make certain that they are good candidates. The criteria are not very restrictive, really just being 42 years of age or less and with some chance of having at least some normal oocytes. That would include the vast majority of infertile couples
Doctor_Scot The restrictions, some times called exclusions, are women with severe problems with the lining of their uterus or women who have diminished ovarian reserve that means they have exhausted their oocyte supply.
Doctor_Scott There are a number of studies which address the safety of biopsy. One of our initial studies will confirm that. At the current time we believe biopsy is safe but to be definitive we will need to complete the study.
Doctor_Scott Regarding cost, the randomized trials do not have a cost for the Pgd and most cycle costs. For the clinical trial where everyone will undergo the process then the costs are the same as for routine care. It really depends what you need and where you fit.
Doctor_Scott Women with recurrent miscarriages are good candidates for one of the three studies
Doctor_Scott Women under thirty usually have great eggs. Hopefully that is the case for you. In the mean time, there is not much anyone can do to change the natural rate at which their egg supply declines and quality changes.
Doctor_Scott The new procedure is a type of Pgd. It is considerably more comprehensive as I can evaluate the entire complement of chromosomes. Conventional Pgd has been disappointing in all but very select groups. We will study this new technique and hope that its greater precision and lower error rate will improve the way we care for our patients
Doctor_Scott You do qualify if you have had a tubal ligation
Doctor_Scott Being on long term oral contraceptives is a safe thing and does not create permanent damage to the ovary or endometrium
Doctor_Scott With prior Pgd, you may still qualify. It would depnd on your entire history. Prior Pgd is an insight into the normality of your oocytes and embryos but is less specific. Hopefully we will do better but the studies are critical to getting this correct
Doctor_Scott The test can be performed on frozen embryos but it takes 48 hours to do so we may have to culture them longer. If they are blasts then they would have to be refrozen. That may nto be in your best interest so be careful
Doctor_Scott We are still recruiting. Just call our office. Contact info can be found at www.rmanj.com
Doctor_Scott Pgd with Fish is not beneficial to a general group of older patients - you are absolutely correct. The reason for that failure are speculative, but most feel that is the lack of precision with the current Pgd technique (fish) and the limited number of chromosomes that were evaluated. Hopefully we will resolve those problems. New studies will tell whether outcomes are improved - but we think they will be
Doctor_Scott Aneuploidy simply means - not the right number. Our goal is to identify in advance those embryos which do not have the right number of chromosomes and as such will not make healthy embryos
Doctor_Scott the technology is very different than Cgh - Cgh compares color based on binding over large areas and is very slow. it can be accurate, but for now many technical limits are not adequately resolved. This is a unique technolgoy which assess the nubmer of chromosomes at over 250,000 sites.
Doctor_Scott Even when the care is routine the cost of Pgd should be substantially less than 5000 dollars
Doctor_Scott I have spent years on the board of both the American Fertility Association and Resolve which are two wonderful patient advocacy groups who are trying to help with insurance. We do support those efforts in many many ways
Doctor_Scott This could be very informative for women with really difficult histories. Still, please remember, this technique identifies if they are chromosomally normal. It does not fix an embryo which has the wrong number. You still need to have some normals to make this successful. Most people do but unfortunately some do not
Doctor_Scott The trials will begin in January and run through early next year
Doctor_Scott the trials will be studying the question about benefit. Clearly no conclusion can ever be reached about the effectiveness of these technique without those types of trials. That is why we are doing a prospective randomized and blinded clinical trial. We want a clear and correct answer
Doctor_Scott The trials require that you have embryos so they do require Ivf
Doctor_Scott The number to transfer typically varies from 1 to 4. it depends on your age and history. Remember that our principal complication is multiple pregnancy. One reason we put more than one back is that you cannot tell if they are competent just by observing them. You need to know about genetics and possibly other factors as well.
Doctor_Scott Regarding intelligence, most studies show that these children (born with the help of invitro) are normal. some have even shown that they are smarter - but they usually have highly motivated parents who take great care and focus on their kids. Comparing them to population norms is probably not fair.
Doctor_Scott It was great talking to everyone tongiht through the chat room. Thanks to NBC for putting this together. Best wishes to all of you. If you need more info you can go to our website or call our office and ask to speak to someone.
Doctor_Scott www.rmanj.com
Doctor_Scott 973-971-4600
Doctor_Scott The patients needs to get seen in our practice so that we can make certain that they are good candidates. The criteria are not very restrictive, really just being 42 years of age or less and with some chance of having at least some normal oocytes. That would include the vast majority of infertile couples
Doctor_Scot The restrictions, some times called exclusions, are women with severe problems with the lining of their uterus or women who have diminished ovarian reserve that means they have exhausted their oocyte supply.
Doctor_Scott There are a number of studies which address the safety of biopsy. One of our initial studies will confirm that. At the current time we believe biopsy is safe but to be definitive we will need to complete the study.
Doctor_Scott Regarding cost, the randomized trials do not have a cost for the Pgd and most cycle costs. For the clinical trial where everyone will undergo the process then the costs are the same as for routine care. It really depends what you need and where you fit.
Doctor_Scott Women with recurrent miscarriages are good candidates for one of the three studies
Doctor_Scott Women under thirty usually have great eggs. Hopefully that is the case for you. In the mean time, there is not much anyone can do to change the natural rate at which their egg supply declines and quality changes.
Doctor_Scott The new procedure is a type of Pgd. It is considerably more comprehensive as I can evaluate the entire complement of chromosomes. Conventional Pgd has been disappointing in all but very select groups. We will study this new technique and hope that its greater precision and lower error rate will improve the way we care for our patients
Doctor_Scott You do qualify if you have had a tubal ligation
Doctor_Scott Being on long term oral contraceptives is a safe thing and does not create permanent damage to the ovary or endometrium
Doctor_Scott With prior Pgd, you may still qualify. It would depnd on your entire history. Prior Pgd is an insight into the normality of your oocytes and embryos but is less specific. Hopefully we will do better but the studies are critical to getting this correct
Doctor_Scott The test can be performed on frozen embryos but it takes 48 hours to do so we may have to culture them longer. If they are blasts then they would have to be refrozen. That may nto be in your best interest so be careful
Doctor_Scott We are still recruiting. Just call our office. Contact info can be found at www.rmanj.com
Doctor_Scott Pgd with Fish is not beneficial to a general group of older patients - you are absolutely correct. The reason for that failure are speculative, but most feel that is the lack of precision with the current Pgd technique (fish) and the limited number of chromosomes that were evaluated. Hopefully we will resolve those problems. New studies will tell whether outcomes are improved - but we think they will be
Doctor_Scott Aneuploidy simply means - not the right number. Our goal is to identify in advance those embryos which do not have the right number of chromosomes and as such will not make healthy embryos
Doctor_Scott the technology is very different than Cgh - Cgh compares color based on binding over large areas and is very slow. it can be accurate, but for now many technical limits are not adequately resolved. This is a unique technolgoy which assess the nubmer of chromosomes at over 250,000 sites.
Doctor_Scott Even when the care is routine the cost of Pgd should be substantially less than 5000 dollars
Doctor_Scott I have spent years on the board of both the American Fertility Association and Resolve which are two wonderful patient advocacy groups who are trying to help with insurance. We do support those efforts in many many ways
Doctor_Scott This could be very informative for women with really difficult histories. Still, please remember, this technique identifies if they are chromosomally normal. It does not fix an embryo which has the wrong number. You still need to have some normals to make this successful. Most people do but unfortunately some do not
Doctor_Scott The trials will begin in January and run through early next year
Doctor_Scott the trials will be studying the question about benefit. Clearly no conclusion can ever be reached about the effectiveness of these technique without those types of trials. That is why we are doing a prospective randomized and blinded clinical trial. We want a clear and correct answer
Doctor_Scott The trials require that you have embryos so they do require Ivf
Doctor_Scott The number to transfer typically varies from 1 to 4. it depends on your age and history. Remember that our principal complication is multiple pregnancy. One reason we put more than one back is that you cannot tell if they are competent just by observing them. You need to know about genetics and possibly other factors as well.
Doctor_Scott Regarding intelligence, most studies show that these children (born with the help of invitro) are normal. some have even shown that they are smarter - but they usually have highly motivated parents who take great care and focus on their kids. Comparing them to population norms is probably not fair.
Doctor_Scott It was great talking to everyone tongiht through the chat room. Thanks to NBC for putting this together. Best wishes to all of you. If you need more info you can go to our website or call our office and ask to speak to someone.
Doctor_Scott www.rmanj.com
Doctor_Scott 973-971-4600









